缺血性脑卒中患者吞咽功能筛查及针对性干预策略的构建和应用效果

Swallowing function screening for ischemic stroke patients and the construction and application effect of targeted intervention strategies

目的考察缺血性脑卒中患者吞咽功能及针对性干预策略的构建和应用效果。方法选取2021年1月至2022年10月于徐州医科大学附属医院诊治的90例缺血性脑卒中患者。根据干预方法的差异分为2组,每组45例。对照组给予常规护理策略,观察组构建吞咽功能筛查指导的针对干预策略并予以实施。比较2组吞咽功能分级、吞咽功能评分、营养水平、生活质量和并发症发生情况。结果干预8周后,观察组的Ⅰ级和Ⅱ级吞咽功能占比均高于对照组,Ⅲ级吞咽功能占比低于对照组(P均<0.05)。干预8周后,观察组的Gugging吞咽功能评估表(GUSS)评分、白蛋白(ALB)、血红蛋白(Hb)水平、吞咽障碍特异性生活质量量表(SWAL-QOL)评分均高于对照组,标准吞咽功能评定量表(SSA)评分均低于对照组(P均<0.05);2组的以上指标和评分比较,均为干预8周优于干预前(P均<0.05)。观察组的并发症总发生率低于对照组(P<0.05)。结论缺血性脑卒中患者吞咽功能筛查及针对性干预策略构建实施有助于改善患者的吞咽功能分级、吞咽障碍和营养水平,能有效提高吞咽功能及生活质量,降低误吸等并发症的发生率。

Objective To examine the swallowing function of ischemic stroke patients and the construction and application effect of targeted intervention strategies.Methods Ninety patients with ischemic stroke who were treated at the Affiliated Hospital of Xuzhou Medical University from January 2021 to October 2022 were selected.They were divided into two groups based on differences in intervention methods,with 45 cases in each group.The control group received routine nursing strategies,while the observation group developed targeted intervention strategies guided by swallowing function screening and implemented them.The swallowing function grading,swallowing function score,nutritional level,quality of life,and incidence of complications were compared between the two groups.Results After 8 weeks of intervention,the proportion of gradeⅠandⅡswallowing function in the observation group were higher than that in the control group,while the proportion of gradeⅢswallowing function in the observation group was lower than that in the control group(all P<0.05).After 8 weeks of intervention,the Gugging Swallowing Screen(GUSS)score,albumin(ALB),hemoglobin(Hb)level,Swallowing Related Quality of Life(SWAL-QOL)score of the observation group were all higher than those of the control group,and the Standardized Swallowing Assessment(SSA)score of the observation group was lower than that of the control group(all P<0.05).The comparison of the above indicators and scores between the two groups showed that after 8 weeks of intervention,it was better than before intervention(all P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion Swallowing function screening and the construction and implementation of intervention strategies for ischemic stroke patients can help improve their swallowing function grading,swallowing disorders,and nutritional levels,effectively improve swallowing function and quality of life,and reduce the incidence of complications such as aspiration.