护士为主导的分级管理策略在脑卒中术后吞咽障碍康复中的价值

Value of nurse-led hierarchical management strategy in rehabilitation of dysphagia after stroke

目的探讨以护士为主导的分级管理策略用于脑卒中术后吞咽障碍康复患者的护理价值。方法选取2019年3月至2021年4月于滨州医学院附属医院收治的脑卒中术后吞咽障碍患者90例,采用随机数字表法将患者分为常规组和试验组,各45例,常规组采用常规康复护理,试验组采用以护士为主导的分级管理策略,比较两组患者吞咽功能、营养状况变化及胃管留置时间差异。结果两组患者护理后3个月与护理前相比,吞咽功能分级均有所升高,且观察组患者吞咽功能分级升高更为显著(P<0.01);观察组患者护理后3个月时的BMI、MAMC均显著高于本组护理前及对照组同期(均P<0.05);观察组患者留置胃管时间较对照组显著减少(P<0.05)。结论护士为主导的分级管理策略用于脑卒中术后吞咽障碍康复患者能够有效减轻吞咽障碍,改善患者营养状态,胃管拔除时间有所提前,适用于脑卒中吞咽障碍的康复阶段。

Objective To explore the nursing value of nurse-led hierarchical management strategy for patients recovering from dysphagia after stroke.Methods A total of 90 patients with dysphagia after stroke treated in this hospital from March 2019 to April 2021 were selected and divided into the conventional group and the experimental group by random number table method,with 45 patients in each group.Patients in the conventional group were treated with routine rehabilitation nursing.Patients in the experimental group were treated with a nurse-led hierarchical management strategy.The changes of swallowing function,nutritional status and retention time of gastric tube were compared between the two groups.Results After 3 months of care,the grade of swallowing function in both groups was higher than that before care,and the grade of swallowing function in the observation group was more significantly higher(P<0.01).After three months of care,the body mass index(BMI)and mid-arm muscle circumference(MAMC)of the observation group was significantly higher than the care before and the control group(P<0.05).The time of indwelling gastric tube in observation group was significantly less than the control group(P<0.05).Conclusions The nurse-led hierarchical management strategy can effectively reduce the dysphagia and improve the nutritional status of patients recovering from dysphagia after stroke surgery,and the gastric tube removal time can be advanced,which is suitable for the rehabilitation stage of dysphagia after stroke.