急性脑卒中吞咽障碍康复护理干预不同介入时间与远期功能改善效果的关系

目的探讨急性脑卒中并发吞咽障碍患者早期康复护理干预在不同时间介入与远期进食功能改善的关系。方法收集神经科监护室、普通病房急性脑卒中并发吞咽障碍103例患者,按从发病到开始康复护理干预介入时间分成4组:A组:00.05)。干预后,A组吞咽功能好于B组,但差异无统计学意义(P>0.05);A组吞咽功能好于C组和D组,差异均有统计学意义(P<0.05,P<0.01)。结论不同介入时间康复护理干预均能积极有效地提高脑卒中吞咽障碍患者远期功能改善率,缩短发病与护理干预措施的间隔时间,更有利于促进吞咽功能的康复,提高患者自主进食能力。

The Relationship between Different Beginning Time and Improved Outcomes of Nursing Rehabilitation Interventions for Acute Cerebral Stroke Patients with Dysphagia

Objective To explore the relationship between different beginning time and improved outcomes of nursing rehabilitation interventions for acute cerebral stroke patients with dysphasia and its effect.Methods 103 of acute cerebral stroke patients with dysphagia from NICU and common wards were divided into four groups by the different beginning time of nursing interventions,time(t) was counted from the onset of the stroke to the beginning of nursing intervention.Group A was 0～ hrs,group B was 48～ hrs,group C was 7 days～,group D was 14～28days.All patients were received 4 weeks comprehensive rehabilitation interventions,which included the instruction of correct feeding position,electric stimulation with triangle curve to fauces,mixture food swallow training,flexibility and coordination training of faucial muscles,the guidance of routine foods feeding and swallow food independently finally.Three kinds of Japanese dysphagia score scales were used to evaluate swallow function of four groups at beginning and at end of 4 weeks intervention and to compare the changes of pre-intervention and post-intervention of each group.Finally post-intervention outcomes were compared between group A and other three groups.Results Four groups’ patients got improvement of wallow function at different levels after the nursing interventions.The improvement after intervention was statistical significant than that before intervention in group A,group B and group C(P<0.01,P<0.05),but no significant in group D(P>0.05).Compared with post-intervention results among groups,there was no significant difference between group A and group B(P>0.05),but significant different between group A and group C or group D(P<0.05).Conclusion Nursing rehabilitation interventions with different beginning time can improve swallow function of cerebral stroke patients.It is more conductive to promoting the rehabilitation of swallowing function and the improvement of patients self-eating by shortening the interval time of onset and nursing intervention.