陈晴 万仁娟 方全凤 曾宪晶 宋青

【摘要】 目的：探讨集束化护理模式在脑卒中后吞咽障碍患者恢复中的效果。方法：选取2020年4-6月本院神经康复科住院部脑卒中后吞咽障碍患者50例作为研究对象。采用随机数字表法将患者分为观察组25例和对照组25例。对照组给予常规护理干预，观察组给予集束化护理模式，两组均干预14 d。比较两组干预前后吞咽功能、吞咽功能特异性生活质量（SWAL-QOL）、神经功能缺损（NIHSS）、日常生活活动能力（ADL）及口腔卫生（MBOAS）评分。结果：干预前，两组吞咽功能、SWAL-QOL、NIHSS、ADL、MBOAS评分比较，差异均无统计学意义（P>0.05）;干预14 d后，观察组吞咽功能、NIHSS、MBOAS评分均低于对照组，SWAL-QOL、ADL评分均高于对照组，差异均有统计学意义（P<0.05）。结论：集束化护理模式可明显改善脑卒中后吞咽障碍患者的吞咽功能。

【关键词】 集束化护理 吞咽障碍 脑卒中 吞咽功能

Effect of Cluster Nursing Model on Dysphagia after Stroke/CHEN Qing， WAN Renjuan， FANG Quanfeng， ZENG Xianjing， SONG Qing. //Medical Innovation of China， 2021， 18（28）： -109

[Abstract] Objective： To explore the effect of cluster nursing model in the recovery of dysphagia after stroke （DAS）. Method： A total of 50 patients with DAS in the Rehabilitation Department of our hospital from April to June 2020 were selected as study objects， they were divided into the observation group （n=25） and the control group （n=25） by random number table. The control group received routine treatment and the observation group received cluster nursing model， two groups were intervened for 14 d. The swallowing function， specific quality of life of deglutition function （SWAL-QOL）， neurological impairment （NIHSS）， activity of daily living （ADL）， oral health （MBOAS） scores between two groups before and after intervention were compared. Result： Before intervention， the scores of swallowing function， SWAL-QOL， NIHSS， ADL and MBOAS of two groups were compared， the differences were not statistically significant （P>0.05）. After 14 d of intervention， the scores of swallowing function ， NIHSS and MBOAS in the observation group were lower than those in the control group， and the scores of SWAL-QOL and ADL were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Cluster nursing model can improve the swallowing function of patients with dysphagia after stroke.

[Key words] Cluster nursing Dysphagia Stroke Swallowing function

First-author’s address： Affiliated Hospital of Jinggangshan University， Ji’an 343000， China

doi：10.3969/j.issn.1674-4985.2021.28.026

腦血管病是我国成年人致死和致残的首位原因[1]，脑卒中发生后有60%～80%患者存在不同程度的功能障碍[2]，其中吞咽障碍是脑卒中患者常见的并发症之一。研究显示：脑卒中急性期吞咽障碍的发生率为37%～78%，而恢复期达16%[3]。临床如未及时干预，易发生吸入性肺炎甚至窒息。因此，改善患者卒中后吞咽功能水平对预后康复具有重要意义。

近年来集束化护理理念逐步得到护理工作者的关注，集束化护理是将证据转化为临床实践的最重要方式，能将分散的护理方法系统化，使得传统的经验主义护理模式向系统规范的护理方向发展而得到医护人员的认可。集束化护理是临床新兴的护理模式之一，明显减少了护理操作的盲目性，使患者能获得最佳的护理方法。……