脑梗死吞咽障碍患者应用临床护理路径的效果观察

目的探讨脑梗死吞咽障碍患者采取临床护理路径的效果。方法选取2020年1月至2021年12月本院收治的脑梗死吞咽障碍患者136例,按照随机数字表法分成两组,对照组(n=68)采取常规护理,观察组(n=68)则基于此同时采用临床护理路径,干预30 d后,通过洼田饮水试验、汉密尔顿焦虑量表(HAMA)和微型营养评定法(MNA)分别评估两组干预前后吞咽功能、心理状态以及营养状态;对比两组肺部感染发生情况。结果干预30 d后相比于干预前,两组患者洼田氏饮水试验法、HAMA分数均降低,而MNA分数升高(P<0.05);且相同时间段观察组与对照组相比较,洼田氏饮水试验法、HAMA分数和肺部感染率更低,而MNA分数更高(P<0.05)。结论临床护理路径可更好促进脑梗死吞咽障碍患者的吞咽功能恢复,改善其心理状态及营养状况,减少肺部感染发生率。

Objective To explore and analyze the effects of clinical nursing pathway on patients with cerebral infarction complicated with dysphagia.Methods A total of 136 patients with cerebral infarction and dysphagia who were admitted to the hospital were selected between January 2020 and December 2021,and they were evenly divided into two groups by random number table method,with 68 cases in each group.Patients of control group adopted routine nursing,while the other group adopted clinical nursing pathway on this basis,and they were intervened for 30 d.The swallowing function[Water Swallow Test],psychological status[Hamilton Anxiety Scale(HAMA)]and nutritional status[Mini-Nutritional Assessment(MNA)]before and after intervention and occurrence of pulmonary infection were compared between the two groups.Results After 30 d of intervention,the scores of Water Swallow Test and HAMA were decreased while MNAscore was increased compared to before intervention in both groups(P<0.05).The scores of Water Swallow Test and HAMA and incidence rate of pulmonary infection were lower while the score of MNA was higher in the experimental group compared to the control group at the same time point(P<0.05).Conclusion Clinical nursing pathway for patients with cerebral infarction complicated with dysphagia can promote the recovery of swallowing function,improve the psychological status and nutritional status,and reduce the risk of pulmonary infection.