纽曼健康系统模式对喉切除患者术后吞咽功能、睡眠质量及康复进程的影响

Impacts of the Neuman systems model on postoperative swallowing function,sleep quality,and rehabilitation progress in patients undergoing laryngectomy

目的 探讨纽曼健康系统模式对喉切除患者术后吞咽功能、睡眠质量及康复进程影响。方法 将2017年1月至2022年1月在衡阳市中心医院行半喉切除术的500例患者作为研究对象,根据是否采用纽曼健康系统模式分为对照组(n=250)和观察组(n=250)。对照组未采用常规模式干预,而观察组采用纽曼健康系统模式干预。比较两组经口进食时间、干预3个月后洼田饮水试验分级及干预前和干预3个月后安德森吞咽困难量表(MDADI)评分、自护能力评分、匹兹堡睡眠质量指数量表(PSQI)评分及睡眠脑电图参数的差异。结果 观察组经口进食时间短于对照组,洼田饮水试验分级中Ⅱ~Ⅴ级发生率低于对照组,差异有统计学意义(P <0.05)。治疗后,两组MDADI评分、自护能力评分均较前升高,PSQI评分较前下降,观察组上述评分均优于对照组,差异有统计学意义(P <0.05)。治疗后,两组睡眠潜伏时间、睡眠构成比较前下降,睡眠总时间较前升高,观察组睡眠脑电图参数优于对照组,差异有统计学意义(P <0.05)。结论 纽曼健康系统模式应用于喉切除可改善患者睡眠质量和吞咽功能,提高自护能力,促进康复。

Objective To explore the impacts of the Neuman Systems Model on postoperative swallowing function,sleep quality,and rehabilitation progress in patients undergoing laryngectomy.Methods A total of 500 patients who underwent hemilaryngectomy in Hengyang Central Hospital from January 2017 to January 2022 were selected as the study subjects,and were divided into the control group(n=250)and observation group(n=250)according to whether Neuman systems model was adopted.The control group receive the intervention of the normal m odel,while the observation group received the intervention of the Neuman systems model.The differences in oral feeding time,the Kubota water swallowing test scores after 3 months of intervention,and M.D.Anderson dysphagia inventory(MDADI)scores,self-care ability scores,Pittsburgh sleep quality index(PSQI)scores,and EEG sleep parameters before intervention and after 3 months of intervention were compared between the two groups.Results The oral feeding time in the observation group was shorter than that in the control group,and the incidence of gradeⅡ-Ⅴscores for swallowing function assessed by Kubota Water Swallowing Test in the observation group was lower than that in the control group,with statistically significant differences(P<0.05).The MDADI scores and self-care ability scores increased after treatment in both groups compared with the baseline scores,while the PSQI scores decreased compared with the baseline scores;the above scores in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).After treatment,the sleep onset latency and wake after sleep onset in both groups decreased compared with the baseline scores,while the total sleep time increased compared with the baseline scores;the EEG sleep parameters in the observation group were better than those in the control group,with statistically significant differences(P<0.05).Conclusion The application of the Neuman Systems Model in laryngectomy can improve patients’sleep quality and swallowing function,enhance their self-care ability,and promote rehabilitation.