不同吞咽功能分级营养管理方案在脑卒中吞咽障碍患者中的应用效果分析

Analysis of application effect of nutritional management programs of different grades of swallowing function in patients with post-stroke dysphagia

目的 探讨不同吞咽功能分级营养管理方案在脑卒中吞咽障碍患者中的应用效果。方法 80例脑卒中吞咽障碍患者作为研究对象,按随机数字编号分为观察组和对照组,每组40例。对照组采用传统护理措施,观察组采用不同吞咽功能分级营养管理方案。比较两组患者治疗前后洼田饮水试验分级、临床疗效、胃管留置时间、吸入性肺炎发生率、营养不良发生率。结果 入院第1天,两组患者的洼田饮水试验分级比较,差异无统计学意义(P>0.05);入院第15天,观察组患者的洼田饮水试验分级优于对照组,差异有统计学意义(P<0.05)。观察组患者的总有效率92.5%高于对照组的75.0%,差异有统计学意义(P<0.05)。观察组患者的胃管留置时间(13.57±1.56)d短于对照组的(19.75±1.66)d,差异有统计学意义(P<0.05)。观察组患者的吸入性肺炎发生率5.0%低于对照组的30.0%,差异有统计学意义(P<0.05)。观察组患者营养不良发生率0低于对照组的5.0%,但差异无统计学意义(P>0.05)。结论 不同吞咽功能分级营养管理方案有利于改善脑卒中后吞咽障碍患者的吞咽功能,对缩短胃管留置时间、降低吸入性肺炎的发生率有重要意义。

Objective To discuss the application effect of nutritional management programs of different grades of swallowing function in patients with post-stroke dysphagia.Methods A total of 80 patients with post-stroke dysphagia were divided into an observation group and a control group according to random numbers,with 40 cases in each group.The control group was treated with conventional nursing measures,and the observation group was treated with nutritional management programs of different swallowing functions.The water swallow test grading before and after treatment,clinical efficacy,time of gastric tube indwelling,incidence of aspiration pneumonia and incidence of malnutrition were compared between the two groups.Results On the 1st day of admission,there was no statistically significant difference in water swallow test grading between the two groups(P>0.05).On the 15th day of admission,the water swallow test grading in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).The total effective rate of 92.5%in the observation group was higher than that of 75.0%in the control group,and the difference was statistically significant(P<0.05).The time of gastric tube indwelling of(13.57±1.56)d in the observation group was shorter than that of(19.75±1.66)d in the control group,and the difference was statistically significant(P<0.05).The incidence of aspiration pneumonia of 5.0%in observation group was lower than that of 30.0%in the control group,and the difference was statistically significant(P<0.05).The incidence of malnutrition of 0 in the observation group was lower than that of 5.0%in the control group,but the difference was not statistically significant(P>0.05).Conclusion Nutritional management programs of different swallowing functions can improve swallowing function of patients with post-stroke dysphagia,shorten the time of gastric tube indwelling and reduce the incidence of aspiration pneumonia.