摘要
目的探讨早期精细化护理干预联合序贯式营养治疗对脑卒中后吞咽功能障碍患者的疗效。方法选取2021年1月至2023年6月四川大学华西医院收治的124例脑卒中后吞咽功能障碍患者为研究对象,在组间基线特征可比的原则上,采用随机数字表法分为对照组和观察组,每组62例。对照组给予常规护理干预联合常规营养治疗,观察组给予早期精细化护理干预联合序贯式营养治疗,两组患者均连续治疗3个月。比较分析两组患者治疗前后的吞咽功能、胃肠道屏障功能[二胺氧化酶(DAO)、D-乳酸]、营养状况[白蛋白(ALB)、血红蛋白(Hb)、转铁蛋白(TF)、前白蛋白(PA)]、心理状况与生活质量[症状自评量表-90(SCL-90)评分、吞咽障碍特异性生活质量量表(SWALQOL)评分]。结果治疗前,两组患者的吞咽功能比较差异均无统计学意义(P>0.05);治疗3个月后,两组患者的吞咽功能与治疗前比较均明显改善,且观察组优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者的DAO、D-乳酸、ALB、Hb、TF、PA、SCL-90评分、SWAL-QOL评分比较差异均无统计学意义(P>0.05);治疗3个月后,两组患者的DAO、D-乳酸、SCL-90评分与治疗前比较均降低,且观察组低于对照组,差异均有统计学意义(P<0.05);治疗3个月后,两组患者的ALB、Hb、TF、PA、SWAL-QOL评分与治疗前比较均升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论早期精细化护理干预联合序贯式营养治疗有利于改善脑卒中后吞咽功能障碍患者的吞咽功能、胃肠道屏障功能、营养状况及心理状况,且可提高患者的生活质量,值得临床应用。
Objective To explore the effect of early nursing refined intervention combined with sequential nutritional therapy on patients with swallowing dysfunction after stroke.Method A total of 124 patients with swallowing dysfunction after stroke admitted to West China Hospital,Sichuan University from January 2021 to June 2023 were selected as the study objects.They were divided into control group and observation group by random number table method based on the principle of comparison of baseline features between two groups,with 62 cases in each group.The control group was given conventional nursing intervention combined with conventional nutritional therapy,and the observation group was given early nursing refined intervention combined with sequential nutritional therapy.Both groups were treated continuously for three months.The swallowing function,gastrointestinal barrier function(DAO,D-lactic acid),nutritional status(ALB,Hb,TF,PA),psychological status and quality of life(SCL-90 score,SWAL-QOL score)before and after treatment were compared between the two groups.Result Before treatment,there was no significant difference in swallowing function between the two groups(P>0.05).After three months of treatment,the swallowing functions in both groups were significantly improved than those before treatment,and the observation group was better than the control group,with statistical significance(P<0.05).Before treatment,there were no significant differences in DAO,D-lactic acid,ALB,Hb,TF,PA,SCL-90 scores and SWAL-QOL scores between the two groups(P>0.05).After three months of treatment,DAO,D-lactic acid and SCL-90 scores in two groups were decreased than those before treatment,and observation group was lower than control group,with statistical significance(P<0.05).After three months of treatment,ALB,Hb,TF,PA and SWAL-QOL scores in two groups were increased than those before treatment,and the observation group was higher than the control group,with statistical significance(P<0.05).Conclusion Early refined nursing intervention combined with sequential nutritional therapy can improve the swallowing function,gastrointestinal barrier function,nutritional status and psychological status of patients with swallowing dysfunction after stroke,and can improve the quality of life of patients,which is worthy of clinical application.
作者
成洋
贺娟
周小莉
Cheng Yang;He Juan;Zhou Xiaoli(General Ward of Neurology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China)
出处
《中国医刊》
CAS
2024年第7期741-745,共5页
Chinese Journal of Medicine
基金
四川省卫生健康委员会科研课题项目(20PJ025)。
关键词
脑卒中
吞咽功能障碍
早期精细化护理干预
序贯式营养治疗
Stroke
Swallowing dysfunction
Early refined nursing intervention
Sequential nutritional therapy
