护士主导的分级摄食管理模式在脑卒中吞咽障碍病人中的应用

李丽芳; 袁丽秀; 肖瑾; 黄莉; 梁梅梅; 梁姗姗

doi:10.13898/j.cnki.issn.1000-2200.2023.07.032

护士主导的分级摄食管理模式在脑卒中吞咽障碍病人中的应用

Application value of nurse-led graded dietary management in stroke patients with dysphagia

摘要

摘要:
目的探讨护士主导的分级摄食管理模式在脑卒中吞咽障碍病人中的应用及效果。
方法选取脑卒中吞咽障碍病人100例，按照随机数字表法分为观察组和对照组，各50例。对照组采用以医生为主导的摄食管理，观察组采用护士主导的分级摄食管理。采用洼田饮水试验评价病人吞咽功能，比较2组病人临床疗效及误吸发生率。
结果干预后，观察组吞咽功能(Ⅰ级19例、Ⅱ级18例、Ⅲ级10例、Ⅳ级2例、Ⅴ级1例)较对照组(Ⅰ级8例、Ⅱ级16例、Ⅲ级12例、Ⅳ级11例、Ⅴ级3例)明显改善(P < 0.01)；观察组临床疗效明显优于对照组(P < 0.01)，误吸发生率明显低于对照组(P < 0.01)。
结论开展护士主导的分级摄食管理，可有效改善脑卒中吞咽障碍病人吞咽功能，提高临床疗效，降低误吸发生率。

Abstract:
ObjectiveTo evaluate the application effects of nurse-led graded dietary management in stroke patients with dysphagia.
MethodsOne hundred stroke patients with dysphagia were randomly divided into the control group and observation group(50 cases in each group).The doctor-led dietary management was given to the control group, and the nurse-led graded dietary management was given to the observation group.The swallowing function in two groups were evaluated using water swallow test.The clinical efficacy and incidence rate of aspiration were compared between two groups.
ResultsAfter intervention, the swallowing function of the observation group(grade Ⅰ 19 cases, grade Ⅱ 18 cases, grade Ⅲ 10 cases, grade Ⅳ 2 cases and grade Ⅴ 1 case) were significantly improved compared with the control group(grade Ⅰ 8 cases, grade Ⅱ 16 cases, grade Ⅲ 12 cases, grade Ⅳ 11 cases and grade Ⅴ 3 cases)(P < 0.01).The clinical efficacy in observation group was significantly better than that in control group(P < 0.05).The aspiration rate in observation group was significantly lower than that in control group(P < 0.01).
ConclusionsThe nurse-led graded dietary management can effectively improve the swallowing function of stroke patients with dysphagia, improve clinical efficacy and reduce the incidence rate of aspiration.

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