卒中吞咽功能障碍患者生活状况及不同体位对吞咽功能影响的研究

A Study on Quality of Life and the Influence of Different Positions on Swallowing Function in Patients with Stroke-Induced Dysphagia

目的 了解卒中吞咽障碍患者生活状况,找到合适的吞咽体位。方法 2023年1月至9月到云南省第三人民医院老年病科、康复医学科因卒中导致吞咽障碍的90例患者作为研究对象,经洼田饮水试验分级后,根据不同洼田饮水试验等级,按30°、60°、90°的检查体位将患者随机分成3组,每组30例,并给患者发放《卒中吞咽功能障碍患者生活状况调查问卷》,分析患者生活状况和不同体位对吞咽功能的影响。结果 患者生活自理能力异常比例为91.11%,轻度焦虑率6.67%,轻度抑郁率16.67%,中度营养风险率91.11%,胃食管反流率36.67%;不同等级吞咽功能障碍患者的生活自理能力、胃食管反流存在差异(P <0.05);30°、60°分别与90°检查体位对比吞咽造影检查发生渗漏、误吸发生率有差异(P <0.05)。结论 卒中吞咽障碍患者的健康状况不太乐观,可以使用30°、60°体位有效降低患者吞咽的渗漏、误吸,通过加强患者健康教育和管理,积极开展营养指导和心理疏导,以及药物、护理、康复训练等综合措施,进一步改善患者的生活质量。

Objective To investigate the quality of life of stroke patients with dysphagia and find the appropriate position for swallowing.Methods From January to September 2023,90 patients with dysphagia caused by stroke were selected from the Department of Geriatrics and Rehabilitation Medicine at the Third People's Hospital of Yunnan Province as study subjects.After the water swallowing test categorization,patients were randomly divided into 3 groups based on different levels of the test-30°,60°,90°examination positions,with each group containing 30 cases.The patients were given a"Stroke Dysphagia Patient Quality of Life Survey"questionnaire to analyze the impact of different positions on swallowing function and the patients'quality of life.Results The proportion of patients with abnormal self-care ability was 91.11%,the rate of mild anxiety was 6.67%,the rate of mild depression was 16.67%,the rate of moderate nutritional risk was 91.11%,and the rate of gastroesophageal reflux was 36.67%.There were differences in self-care ability and gastroesophageal reflux among patients with different levels of swallowing dysfunction(P<0.05).There were differences in the incidence of leakage and aspiration in the 30°,60°and 90°positions respectively(P<0.05).Conclusion The health status of stroke patients with dysphagia is concerning.The use of the 30°and 60°positions can effectively reduce the leakage and aspiration of the patients'swallowing.By enhancing patient health education and management,actively providing nutritional guidance and psychological support,as well as comprehensive measures such as medication,care,and rehabilitation training,the quality of life of patients can be further improved.