基于奥马哈系统的综合康复护理干预在脑卒中后吞咽障碍患者中的实施价值

Implementation Value of Comprehensive Rehabilitation Nursing Intervention Based on Omaha System on Patients with Dysphagia after Stroke

目的:探究基于奥马哈系统的综合康复护理干预在脑卒中后吞咽障碍患者中的实施价值。方法:选取2020年1月-2021年2月柳州市人民医院70例脑卒中后吞咽障碍患者。根据随机法将其分为对照组和观察组,每组35例。对照组给予常规护理干预,观察组给予基于奥马哈系统的综合康复护理干预。比较两组出院当天,出院1、3个月后的吞咽功能及出院当天,出院3个月后的营养状况,出院3个月后的生活质量。结果:观察组出院1、3个月后的吞咽视频内镜检查(VESS)评分均高于对照组,Rosenbek渗透/误吸量表(PAS)评分均低于对照组(P<0.05)。观察组出院3个月后的血红蛋白(Hb)、血清白蛋白(ALB)及转铁蛋白(TRF)水平均高于对照组(P<0.05)。出院3个月后,观察组EORTC生命质量测定量表QLQ-C30 (V30)中文版(EORTC QLQ C30)、EORTC生命质量测定量表QLQ-H&N35 (V1.0)中文版(EORTC QLQ-H&N35)评分均高于对照组(P<0.05)。结论:脑卒中后吞咽障碍实施基于奥马哈系统的综合康复护理干预,可持续改善患者吞咽功能、营养水平与生活质量。

Objective:To explore the implementation value of comprehensive rehabilitation nursing intervention based on Omaha system on patients with dysphagia after stroke.Method:Seventy patients with dysphagia after stroke in Liuzhou People’s Hospital from January 2020 to February 2021 were selected.They were divided into control group and observation group by random method,35 cases in each group.The control group was given routine nursing intervention,the observation group was given comprehensive rehabilitation nursing intervention based on Omaha system.The swallowing function on discharge day,after 1 and 3 months of discharge,nutritional status on discharge day,after 3 months of discharge,and quality of life after 3 months of discharge of the two groups were compared.Result:The score of video endoscopy swallowing study (VESS) in the observation group after 1 and 3 months of discharge was higher than that in the control group,and the score of Rosenbek penetration/aspiration scale (PAS) was lower than that in the control group (P<0.05).The levels of hemoglobin (Hb),serum albumin (ALB) and serum transferrin (TRF) in the observation group were higher than those in the control group after 3 months of discharge (P<0.05).After 3 months of discharge,the scores of EORTC quality of life scale QLQ-C30 (V30) Chinese version (EORTC QLQ C30) and EORTC quality of life scale QLQ-H&N35 (V1.0) Chinese version (EORTC QLQ-H&N35) in the observation group were higher than those in the control group (P<0.05).Conclusion:The implementation of comprehensive rehabilitation nursing intervention based on Omaha system in dysphagia after stroke can continuously improve swallowing function,nutrition level and quality of life of patients.