集束化综合干预对脑卒中后吞咽功能障碍患者负性情绪及疾病康复的影响

Influence of cluster comprehensive intervention on negative emotion and disease rehabilitation of cerebral stroke patients with swallowing dysfunction

目的:探究集束化综合干预对脑卒中后吞咽功能障碍患者的影响。方法:以2018年1月-2020年1月某院收治的120例脑卒中后吞咽功能障碍患者为研究对象,随机分为对照组(n=60)和观察组(n=60),对照组给予一般干预,观察组在常规基础上给予集束化综合干预。比较两组负性情绪[焦虑自评量表(SAS)和抑郁自评量表(SDS)]、肺功能[用力肺活量(FVC)、1秒用力呼气量(FEV1)、峰值呼气流速(PEF)]、吞咽功能[标准吞咽功能评定(SSA)和功能性吞咽困难评分(FDS)]、神经功能和日常生活功能[美国国立卫生研究院卒中量表(NIHSS)和采用修订的Barthel指数(MBI)]及生活质量[健康状况调查简表(SF-36)]。结果:干预前,观察组和对照组的SAS评分和SDS评分、FVC、FEV1、PIF、SSA评分和FDS评分、NIHSS评分、MBI的评分均无显著差异。干预后,观察组SAS评分和SDS评分显著低于对照组(t=-4.451,-4.689;P<0.001);观察组的FVC、FEV1、PIF显著高于对照组(t=6.692,8.065,4.788;P<0.001);观察组的SSA评分和FDS评分显著低于对照组(t=-9.803,-9.201;P<0.001);观察组的NIHSS评分显著低于对照组(t=-4.944,P<0.001),MBI的评分显著高于对照组(t=4.632,P<0.001);观察组的SF-36各维度评分显著高于对照组(t=4.332,4.222,6.439,8.329,3.404;P<0.001)。结论:针对脑卒中后吞咽功能障碍患者而言,集束化综合干预可明显减轻患者负性情绪,改善患者肺功能,促进患者吞咽、神经和日常生活功能的恢复,提升生活质量。

Objective:To investigate the influence of cluster comprehensive intervention on negative emotion and disease rehabilitation of cerebral stroke patients with swallowing dysfunction.Methods:A total of 120 cerebral stroke patients with swallowing dysfunction admitted to our hospital from January 2018 to January 2020 were selected as the research objects and randomly divided into control group(n=60)and observation group(n=60).The control group received general intervention,while the observation group received cluster comprehensive intervention.Negative emotion[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)],lung function[forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and peak expiratory flow(PEF)],swallowing function[scores of standardized swallowing assessment(SSA)and functional dysphagia scale(FDS)],neurological function and activity of daily living[the national institutes of health stroke scale(NIHSS)and adoption of modified barthel index(MBI)]and living quality[short form 36 health survey questionnaire(SF-36)]were compared between the two groups.Results:After intervention,the scores of the SAS and SDS of the observation group were significantly lower than those of the control group(t=-4.451,-4.689;P<0.001);After intervention,FVC,FEV1 and peak of inspiratory flow(PIF)in the observation group were significantly higher than those in the control group(t=6.692,8.065,4.788;P<0.001);After intervention,the scores of the SSA and FDS of the observation group were significantly lower than those of the control group(t=-9.803,-9.201;P<0.001);After intervention,the scores of the NIHSS in the observation group were significantly lower than those in the control group(t=-4.944,P<0.001),And the scores of MBI were significantly higher than those in the control group(t=4.632,P<0.001);And after intervention,the scores of different dimensions of the SF-36 in the observation group were significantly higher than those in the control group(t=4.332,4.222,6.439,8.329,3.404;P<0.001).Conclusion:For the cerebral stroke patients with swallowing dysfunction,cluster comprehensive intervention can reduce their negative emotion obviously,improve their lung function,promote recovery of their swallowing function,neurological function and activity of daily living,and improve living quality.