冯婉芬 左杏梅 黄幼平

【摘要】 目的：探討不同病房管理模式对脑卒中留置胃管患者发生反流和吸入性肺炎的影响。方法：选取2018年1月-2019年3月在笔者所在医院重症医学科治疗的需要留置胃管的脑卒中患者86例，按照随机数字表法分为研究组和对照组，每组43例。对照组给予常规病房管理模式，研究组给予三级病房管理模式，观察周期为1周。对比两组胃管反流发生次数、吸入性肺炎发生率、防误吸认知度得分、患者治疗依从性和护理满意度。结果：研究组发生胃管反流次数少于对照组，研究组吸入性肺炎发生率（0）低于对照组（18.60%），差异均有统计学意义（P<0.05）;研究组家属防误吸知识得分高于对照组，研究组治疗依从性和护理满意度均高于对照组，差异均有统计学意义（P<0.05）。结论：三级病房管理模式可提高脑卒中留置胃管患者家属对误吸相关知识的认识，从而有效提升患者治疗依从性和护理满意度，降低胃管反流和吸入性肺炎发生概率。

【关键词】 脑卒中 三级病房管理模式 胃管反流 吸入性肺炎 依从性

doi：10.14033/j.cnki.cfmr.2020.13.065 文献标识码 B 文章编号 1674-6805（2020）13-0-03

Effect of Different Ward Management Modes on the Incidence of Reflux and Aspiration Pneumonia in Stroke Patients with Gastric Tube/FENG Wanfen， ZUO Xingmei， HUANG Youping. //Chinese and Foreign Medical Research， 2020， 18（13）： -159

[Abstract] Objective： To explore the effect of different ward management modes on the incidence of reflux and aspiration pneumonia in stroke patients with gastric tube. Method： A total of 86 stroke patients who needed gastric tube from January 2018 to March 2019 in the Department of Critical Medicine of our hospital were divided into the study group and the control group according to the random number table method， 43 cases in each group. The control group was given conventional ward management mode， the study group was given three-level ward management mode， the observation period was 1 week. The number of gastric tube regurgitation， the incidence of aspiration pneumonia， the score of anti-misabsorption recognition， the patients treatment compliance and nursing satisfaction were compared between the two groups. Result： The number of gastric tube reflux in the study group was less than that in the control group， the incidence of aspiration pneumonia in the study group （0） was lower than that in the control group （18.60%）， the differences were statistically significant （P<0.05）. The scores of anti-suction knowledge in the study group was higher than that in the control group， the treatment compliance and nursing satisfaction in the study group were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The three-level ward management model can improve the understanding of the family members of stroke patients with indwelling gastric tube about the knowledge of aspiration by mistake， so as to effectively improve the patients treatment compliance and nursing satisfaction， and reduce the probability of gastric tube reflux and aspiration pneumonia.

[Key words] Stroke Tertiary ward management mode Gastric reflux Aspiration pneumonia Compliance

First-authors address： Foshan Fifth Peoples Hospital， Foshan 528211， China

脑卒中是因脑部血液循环障碍所致的脑神经功能损害的综合征，该类患者多存在吞咽障碍，往往需要留置胃管鼻饲进食，以满足机体营养需求[1]。鼻饲患者因护理措施不当易导致胃管反流和吸入性肺炎等严重并发症，增加患者生理和心理负担[2]。常规病房管理模式，因护理工作量大、人员不足等原因无法取得理想的护理效果[3]。三级病房管理模式实现了患者的集中管理，增强了医护人员与家属的沟通，已在重型颅脑损伤、呼吸道感染和发热患者的护理中取得较好的运用效果[4-5]。本研究将三级病房管理模式引入脑卒中留置胃管患者的管理中，与常规护理模式进行比较并观察效果，结果通报如下。

1 资料与方法