延续护理对居家脑卒中吞咽障碍患者的影响分析(1)
[摘要] 目的 研究延续护理对居家脑卒中吞咽障碍患者的影响。方法 随机选取96例于2011年2月—2012年8月间就诊的脑卒中吞咽障碍患者，将其分为对照组和观察组，各48例。对照组实施常规护理，观察组在常规护理基础上进行6个月的延续护理干预。出院后定期随访，于入院前、出院时、出院1个月、2个月、4个月、6个月时对患者进行饮水试验评估患者吞咽功能，同时记录并发症发生情况，比较组间差异。 结果 ①研究发现，入院前、出院时两组患者饮水试验评分差异无统计学意义，出院后两组患者评分开始降低，吞咽功能改善，出院1个月时组间比较差异无统计学意义，出院2、4、6个月时观察组评分明显低于对照组，P<0.05，差异有统计学意义。②6个月后，观察组吸入性肺炎、误吸、呛咳发生率明显低于对照组，两组总发生率分别为14.6%、89.6%，P<0.05，差异有统计学意义。结论 延续护理可有效改善居家脑卒中吞咽障碍，并发症发生率明显降低，值得临床借鉴。
[关键词] 延续护理；脑卒中；吞咽障碍
[中图分类号] R47 [文献标识码] A [文章编号] 1674-0742(2016)08(a)-0168-04
[Abstract] Objective To study the clinical effect of continuous nursing care on patients with dysphagia after stroke. Methods 96 patients in February 2011 to August 2012 with dysphagia after stroke were selected and divided them into study group and control group. Routine nursing for control group， while observation group in the conventional care based on the continuation of care， for a period of 6 months. Regular follow-up after discharge， and drinking water test was conducted to evaluate the swallowing function of patients before and after discharge， 1 months， 2 months， 4 months and 6 months after discharge. The complications were recorded and the differences were compared between the two groups. Results ①The study found that there were no significant difference of water test score of patients in the two groups when eprior to admission and discharge. Scores of two groups began to decrease after discharge.There was no significant difference between the two groups at 1 months， the score of the observation group was significantly lower than that of the control group in 2 months， 4 months and 6 months，P < 0.05， the difference was significant.②After 6 months， the incidence of aspiration pneumonia， aspiration and cough in the observation group was significantly lower than that in the control group， and the total incidence rate of the two groups was 14.6%， 89.6%， P < 0.05， the difference was significant. Conclusion Continuous nursing can effectively improve the swallowing dysfunction of stroke patients at home， and the incidence of complications was significantly reduced， which it is worth learning from.
[Key words] Continuous nursing； Cerebral apoplexy； Swallowing disorder
脑卒中在中国发病普遍，多见于中老年患者。流行病学资料显示[1]，中国农村脑卒中发病率高达2.8‰，城区发病率高达3.9‰。吞咽障碍是食物从口腔不能顺利进入胃肠道，易出现呛咳等症状，是脑卒中常见并发症，大大增加了病死率[2-3]。为有效提高患者出院后的护理依从性、满意度和生活质量，在患者出院后居家过程中开启延续护理模式，对患者各方面进行护理指导，以改善临床治疗效果[4]。该次研究对96例2011年2月—2012年8月间该院收治的患者进行延续护理干预与常规护理的效果对比，现报道如下。
1 资料与方法 (程吉英)
[关键词] 延续护理；脑卒中；吞咽障碍
[中图分类号] R47 [文献标识码] A [文章编号] 1674-0742(2016)08(a)-0168-04
[Abstract] Objective To study the clinical effect of continuous nursing care on patients with dysphagia after stroke. Methods 96 patients in February 2011 to August 2012 with dysphagia after stroke were selected and divided them into study group and control group. Routine nursing for control group， while observation group in the conventional care based on the continuation of care， for a period of 6 months. Regular follow-up after discharge， and drinking water test was conducted to evaluate the swallowing function of patients before and after discharge， 1 months， 2 months， 4 months and 6 months after discharge. The complications were recorded and the differences were compared between the two groups. Results ①The study found that there were no significant difference of water test score of patients in the two groups when eprior to admission and discharge. Scores of two groups began to decrease after discharge.There was no significant difference between the two groups at 1 months， the score of the observation group was significantly lower than that of the control group in 2 months， 4 months and 6 months，P < 0.05， the difference was significant.②After 6 months， the incidence of aspiration pneumonia， aspiration and cough in the observation group was significantly lower than that in the control group， and the total incidence rate of the two groups was 14.6%， 89.6%， P < 0.05， the difference was significant. Conclusion Continuous nursing can effectively improve the swallowing dysfunction of stroke patients at home， and the incidence of complications was significantly reduced， which it is worth learning from.
[Key words] Continuous nursing； Cerebral apoplexy； Swallowing disorder
脑卒中在中国发病普遍，多见于中老年患者。流行病学资料显示[1]，中国农村脑卒中发病率高达2.8‰，城区发病率高达3.9‰。吞咽障碍是食物从口腔不能顺利进入胃肠道，易出现呛咳等症状，是脑卒中常见并发症，大大增加了病死率[2-3]。为有效提高患者出院后的护理依从性、满意度和生活质量，在患者出院后居家过程中开启延续护理模式，对患者各方面进行护理指导，以改善临床治疗效果[4]。该次研究对96例2011年2月—2012年8月间该院收治的患者进行延续护理干预与常规护理的效果对比，现报道如下。
1 资料与方法 (程吉英)