摄食指导联合吞咽功能训练在多发性肌炎合并吞咽障碍患者中的应用效果

Application effects of feeding guidance combined with swallowing function training in patients with polymyositis complicated with dysphagia

目的:观察摄食指导联合吞咽功能训练在多发性肌炎合并吞咽障碍患者中的应用效果。方法:选取64例多发性肌炎合并吞咽功能障碍患者为研究对象,按照随机数字表法分为对照组和观察组各32例。对照组采用常规护理,观察组在对照组基础上采用摄食指导联合吞咽功能训练,比较两组临床疗效、护理前后生命质量[安德森吞咽困难量表(MDADI)]评分、营养指标[血红蛋白(Hb)、白蛋白(ALB)、上臂三头肌肌围(MAMC)]水平及并发症发生率。结果:观察组治疗总有效率为87.50%,高于对照组的59.38%,差异有统计学意义(P<0.05);干预后,观察组总体状况、情感、功能、生理等生命质量评分均高于对照组,差异均有统计学意义(P<0.05);观察组Hb、ALB、MAMC水平均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为3.13%,低于对照组的28.13%,差异有统计学意义(P<0.05)。结论:摄食指导联合吞咽功能功能训练联合常规护理应用于多发性肌炎合并吞咽障碍患者,可提高临床疗效和营养指标水平,提高生命质量,且可降低并发症发生率,其效果优于单纯常规护理。

Objective: To observe application effects of feeding guidance combined with swallowing function training in patients with polymyositis complicated with dysphagia. Methods: 64 patients with polymyositis complicated with dysphagia were selected as the research objects and were divided into control group and observation group according to the random number table method, 32 cases in each group. The control group received routine nursing, while the observation group received feeding guidance combined with swallowing function training on the basis of that of the control group. The clinical efficacy, the quality of life [Anderson dysphagia inventory(MDADI)] score, the nutritional indicators [hemoglobin(Hb), albumin(ALB), upper arm triceps muscle circumference(MAMC)] levels and the incidence of complications were compared between the two groups. Results: The total effective rate of the observation group was 87.50%, which was higher than 59.38% of the control group, and the difference was statistically significant(P<0.05). After the intervention, the levels of Hb, ALB and MAMC in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). The overall condition, emotion, function, physiology and other quality of life scores of the observation group were higher than those of the control group, and the differences were statistically significant(P<0.05). Further,the incidence of complications in the observation group was 3.13%, which was lower than 28.13% in the control group, and the difference was statistically significant(P<0.05). Conclusions: Feeding guidance combined with swallowing function training and routine nursing in the patients with polymyositis complicated with dysphagia can improve clinical efficacy and the nutritional indicator levels, improve the quality of life, and reduce the incidence of complications. Moreover, it is superior to single routine nursing.