摘要
目的研究集束化护理对脑卒中吞咽障碍患者鼻肠管的实施效果。方法选择2016年8月至2017年6月在山东省千佛山医院神经内科住院的留置鼻肠管的脑卒中伴吞咽功能障碍患者102例为研究对象。采用随机数字表法，将上述患者分为试验组和对照组各51例，分别给予集束化护理和常规鼻肠管护理。对2组一次置管成功率、留置鼻肠管并发症、住院天数和费用以及患者满意度等方面进行比较。结果试验组的一次置管成功率78．4％（40／51），显著高于对照组的54．9％（28／51），差异有统计学意义（r=6．353，P〈0．05）；留置鼻肠管并发症，包括非计划拔管、反流误吸、管饲相关性腹泻方面的发生率分别为9．8％（5／51）、17．6％（9，51）、11．8％（6／51），均明显低于对照组的37．3％（19／51）、41．2％（21，51）、31．4％（16，51），差异有统计学意义（χ2=10．679、6．800、5．795）；住院天数和住院费用分别为（11．0±2．5）d、（9645．35±193．30）元，明显低于对照组的（17．0±4．2）d、（12523．79±190．28）元，差异有统计学意义（t=8．767、10．612，P〈0．01），患者满意度为90．2％（46／51），显著高于对照组的68．6％（35／51），差异有统计学意义（χ2=7．256，P〈0．01）。结论对脑卒中吞咽功能障碍患者实施鼻肠管集束化护理，可有效增加一次置管成功率，减少留置鼻肠管并发症的发生，可能因此有效降低患者吸人性肺炎的发生。此外，集束化护理可明显降低患者医疗负担，缩短住院时间，提高患者生命质量。
Objective The study was aimed to explore the effect of care bundles on the management of nasal intestine for the cerebral apoplexy patients with dyspinic dysfunction. Methods A total of 102 cerebral apoplexy patients with dyspinic dysfunction, who were administrated with nasal intestine, were recruited in Qianfoshan Hospital of Shandong Province from August, 2016 to June, 2017. Random number table was applied to analyze the separate two groups, experimental group and control group, in which, the patients were administrated with care bundles and usual care. Various parameters, like one-time catheterization, complications of nasal intestine administration, hospital stay, cost and the patients＂ satisfaction degree, were compared between two groups. Results The success rate of once placed tube in the test group was 78.4% （40/51）, which was significantly higher than that in the control group [54.9% （28/51）], and the difference was statistically significant （χ2= 6.353, P 〈 0.05）. The incidence of complications of indwelling nasoenteric tube, including unplanned extubation, reflux aspiration, tube- feeding associated diarrhea, were 9.8% （5/51）, 17.6% （9/51）, 11.8% （6/51）, respectively. All of them were significantly lower than those of the control group, which were 37.3% （19/51）, 41.2% （21/51）, 31.4% （16/ 51）, respectively, indicating that there was a statistical difference （χ2 = 10.679, 6.800, 5.795）. The days and costs of hospitalization were （11.0± 2.5） d, （9 645.35 ±195.30） yuan, respectively, which weresignificantly lower than those of the control group [（17.0 ± 4.2） d, （12 523.79± 190.28） yuan], indicating that there was a statistical difference （t = 8.767, 10.612, P 〈 0.01）. Patients＂ satisfaction was 90.2% （46/ 51）, which was significantly higher than that of the control group [68.6% （35/51）]. The difference was statistically significant （χ2 = 7.256, P 〈 0.01）. Conclusions The administration of care bundles for the cerebral apoplexy patients with dyspinie dysfunction can effectively increase the success rate of one-time catheterization, alleviate the complications, and therefore reduce the risk of aspiration pneumonia development. In addition, care bundles can remarkably alleviate the medical burden on the patients, shorten the hospital stays and improve the survival quality of the patients.
作者
韩梅
薛秀娟
邓传耀
张淑香
Han Mei;Xue Xiujuan;Deng Chuanyao;Zhang Shuxiang.(Department of Health Care Internal Medicine,Qianfoshan Hospital of Shandong Province,Jinan 250014,China)
出处
《中国实用护理杂志》
2018年第26期2017-2021,共5页
Chinese Journal of Practical Nursing
关键词
卒中
集束化护理
吞咽功能障碍
鼻肠管
Stroke
Care bundles
Dyspinic dysfunction
Nasal intestine
