Application and observation of IOE combined with "open-throat massage method"in rehabilitation care of patients with dysphagia after stroke
IOE联合“开窍利咽按摩法”在脑卒中后吞咽障碍患者康复护理中的应用与观察

摘要

目的 观察间歇性经口至食管管饲法（IOE）联合“开窍利咽按摩法”在脑卒中后吞咽障碍患者康复护理中的应用效果。方法 选取康复医学科收治的100例脑卒中后吞咽障碍患者，采用随机数字表法分为观察组（间歇性经口至食管管饲法（IOE）联合“开窍利咽按摩法”组）和对照组（普通留置胃管喂养），每组各50例。均连续干预4周。比较两组干预前及干预4周后的吞咽功能[采用Rosenbek渗透-误吸量表（PAS）评分]、吞咽障碍程度（VGF）评分、生活质量[采用吞咽障碍特异性生活质量量表（SWAL-QOL）评估]，统计干预期间并发症发生情况。结果 干预4周后，两组PAS评分较干预前降低，VGF评分较治疗前升高，且观察组PAS评分低于对照组，VGF评分高于对照组，差异有统计学意义（P＜0.05）；两组干预4周后SWAL-QOL评分均较干预前升高，且观察组高于对照组，差异有统计学意义（P＜0.05）；两组干预期间的并发症总发生率比较，差异无统计学意义（P＞0.05）。结论 脑卒中后吞咽障碍患者在康复护理期间采用间歇性经口至食管管饲法（IOE）联合“开窍利咽按摩法”，可提高患者康复护理疗效，患者生活质量及吞咽功能均明显改善，值得临床应用推广。

Abstract

Objective To observe the application effect of intermittent oral-to-esophageal feeding (IOE) combined with "open-minded pharyngeal massage" in the rehabilitation nursing of patients with dysphagia after stroke.
Methods A total of 100 patients with dysphagia after stroke admitted to the Department of Rehabilitation Medicine were divided into observation group (intermittent oral-to-esophageal feeding (IOE) combined with "open pharyngeal massage") and control group (ordinary indwelling gastric tube feeding) and 50 cases in each group. All were continuously intervened for 4 weeks. The swallowing function [Rosenbek osmosis-aspiration scale (PAS) score], swallowing disorder degree (VGF) score, and quality of life [assessed by swallowing disorder-specific quality of life scale (SWAL-QOL)] were compared between the two groups before and after the intervention, and the incidence of complications during the intervention was statistically measured.
Results After 4 weeks of intervention, the PAS score of the two groups was lower than that before the intervention, the VGF score was higher than that before treatment, and the PAS score of the observation group was lower than that of the control group, and the VGF score was higher than that of the control group, with a statistically significant difference (P<0.05), the SWAL-QOL score of the two groups after 4 weeks of intervention was higher than that before the intervention, and the observation group was higher than that of the control group (P<0.05), and the total incidence of complications during the intervention period between the two groups was not statistically significant (P>0.05).
Conclusion   During rehabilitation nursing for patients with dysphagia after stroke, intermittent oral to esophageal tube feeding (IOE) combined with "opening orifice and nourishing pharynx massage" can improve the curative effect of rehabilitation nursing, and the quality of life and swallowing function of patients are significantly improved, which is worthy of clinical application and promotion.