连续性风险管理联合常规吞咽康复治疗在脑卒中吞咽障碍患者中的应用效果观察

Observation on Application Effect of Continuous Risk Management Combined with Routine Swallowing Rehabilitation Treatment in Stroke Patients with Dysphagia

目的:探讨连续性风险管理联合常规吞咽康复治疗在脑卒中吞咽功能障碍患者中的应用效果。方法:选取2020年7月—2021年6月北京市丰台康复医院神经内科收治的脑卒中吞咽障碍患者40例作为研究对象,根据随机数字表法分为对照组和观察组,各20例。对照组给予常规吞咽康复治疗,观察组在常规吞咽康复治疗基础上进行连续性风险管理。比较两组干预效果。结果:干预后,两组吞咽功能量表评分低于干预前,且观察组低于对照组,两组日常生活能力评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。干预后,观察组白蛋白、前白蛋白、血红蛋白水平均高于对照组,差异有统计学意义(P<0.05)。观察组误吸及吸入性肺炎总发生率低于对照组,差异有统计学意义(P=0.042)。结论:脑卒中吞咽障碍患者进行常规吞咽康复治疗联合连续性风险管理的效果显著,可促进吞咽功能恢复,提高日常生活能力,改善营养状况,减少不良事件。

Objective:To investigate the application effect of continuous risk management combined with routine swallowing rehabilitation treatment in stroke patients with swallowing dysfunction.Methods:A total of 40 stroke patients with dysphagia admitted to the Department of Neurology of Fengtai Rehabilitation Hospital of Beijing Municipality from July 2020 to June 2021 were selected as the study subjects.They were divided into observation group and control group according to random number table method,with 20 cases in each group.The control group was given routine swallowing rehabilitation treatment,and the observation group was given continuous risk management based on routine swallowing rehabilitation treatment.The therapeutic effect of the two groups was compared.Results:After intervention,the swallowing function scale scores in two groups were lower than those before intervention,and the observation group was lower than the control group,while the activity of daily living scores in two groups were higher than those before intervention,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After the intervention,the levels of albumin,prealbumin and hemoglobin in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of aspiration and aspiration pneumonia in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.042).Conclusion:Routine swallowing rehabilitation treatment combined with continuous risk management has a significant effect in stroke patients with dysphagia,which can promote the recovery of swallowing function,improve the activity of daily living,ameliorate the nutrition status and reduce adverse events.