误吸风险分级护理在神经内科老年患者中的应用效果

赵秋美; 司马振奋

doi:10.16766/j.cnki.issn.1674-4152.001940

误吸风险分级护理在神经内科老年患者中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.001940

赵秋美^1, ,,
司马振奋²

1.
绍兴市人民医院神经内科二，浙江绍兴 312000
2.
绍兴市人民医院康复科，浙江绍兴 312000

基金项目:

浙江省医药卫生科技计划项目 2020RC129

详细信息

通讯作者:
赵秋美, E-mail: 13735374337@qq.com

中图分类号: R473.74
计量
- 文章访问数: 113
- HTML全文浏览量: 36
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2020-12-21
- 网络出版日期: 2022-02-16

Application effect of grading nursing of accidental aspiration risk in among elderly patients in eurological department

ZHAO Qiu-mei^{1
, ,},
SIMA Zhen-fen²

1.
Department of Neurology, Shaoxing People's Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的探讨误吸风险分级护理神经内科老年患者的应用效果，为临床提供参考依据。方法选取2018年8月—2020年8月绍兴市人民医院神经内科住院治疗的182例老年患者为研究对象。按照随机数字法将患者分为对照组和观察组，各91例。对照组给予常规入院护理评估和干预，内容包括：入院宣教、常规饮食指导、出院指导等。观察组根据GUSS评分进行误吸风险分级，然后依照误吸风险分级给予针对性护理。观察并记录2组患者误吸发生率、吸入性肺炎发生率、GUSS吞咽功能评分，同时对比患者满意度。结果观察组误吸发生率和吸入性肺炎发生率分别是为7.69%和2.20%，显著低于对照组的35.16%、15.38%，差异有统计学意义(χ²=20.396、9.867，均P < 0.05)。观察组GUSS评分和护理满意度评分分别是(16.87±3.12)分、(95.23±2.07)分，显著高于对照组[(16.87±3.12)分、(90.41±2.13)分]，差异有统计学意义(t=3.679、15.481，均P < 0.05)。结论误吸风险分级护理能够有效地降低神经内科老年患者误吸的发生率，改善患者的吞咽功能，提高了护理质量。
- 误吸 /
- 风险 /
- 护理 /
- 神经内科
Abstract: Objective To study the application effect of grading nursing of aspiration risk in neurological elderly patients and provide reference for clinical. Methods A total of 182 elderly patients in the Department of Neurology of Shaoxing People's Hospital from August 2018 to August 2020 were selected as the research objects. The patients were randomly divided into control group and observation group with 91 cases in each group. Patients in the control group were offered routine nursing intervention and assessment including discharge admission education, dietary instructions and discharging guidance among others. Relative to patients in the observation group, risk of accidental aspiration was graded according to their GUSS score first, then targeted interventions were implemented. The incidence of accidental aspiration, incidence of aspiration pneumonia, GUSS score and patient satisfaction were compared between the two groups. Results The incidence of accidental aspiration and incidence of aspiration pneumonia in the observation group were 7.69% and 2.20%, respectively, which were significantly lower than those of the control group, with 35.16% and 15.38% (χ²= 20.396, 9.867, P < 0.05). The GUSS score and patient satisfaction score in the observation group were (16.87±3.12) points and (95.23±2.07) points, respectively which were significantly higher than those of the control group, with (16.87±3.12) points and (90.41±2.13) points (t=3.679, 15.481, P < 0.05). Conclusion Grading nursing of aspiration risk can effectively reduce the incidence of aspiration in elderly patients in eurological department, improve the swallowing function of inpatients and promote the quality of nursing, and thus, it is worthy of clinical promotion.
- Accidental aspiration /
- Risk /
- Nursing /
- Department of Neurology

HTML全文

表 1 2组神经内科住院患者吞咽功能GUSS评分和护理满意度比较(x±s, 分)

组别	例数	GUSS评分	护理满意度评分
对照组	91	15.19±3.04	90.41±2.13
观察组	91	16.87±3.12	95.23±2.07
t值		3.679	15.481
P值		< 0.001	< 0.001

下载: 导出CSV

参考文献(19)

[1]	贺文文. 老年阿尔茨海默病患者发生误吸/窒息的相关因素分析[J]. 中华全科医学, 2017, 15(4): 708-711. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201704050.htm
[2]	陈永红, 王兆伟. 神经内科患者安全隐患及预防对策[J]. 西南国防医药, 2015, 25(6): 669-671. doi: 10.3969/j.issn.1004-0188.2015.06.036
[3]	MOMOSAKI R. Rehabilitative management for aspiration pneumonia in elderly patients[J]. J Gen Fam Med, 2017, 18(1): 12-15.
[4]	张红霞, 周建妹. 住院老年患者误吸发生率及危险因素的调查[J]. 老年医学与保健, 2017, 23(6): 570-571, 579. doi: 10.3969/j.issn.1008-8296.2017.06.036
[5]	徐文芳, 陈凤, 王小芳, 等. 鼻肠管联合胃管营养支持对长期机械通气患者预防误吸的影响[J]. 中国实用护理杂志, 2016, 32(10): 765-766. doi: 10.3760/cma.j.issn.1672-7088.2016.10.013
[6]	戴卉, 周辰, 潘晓东, 等. 吞咽功能训练预防老年吞咽障碍病人肠内营养误吸的研究[J]. 实用老年医学, 2018, 32(3): 293-294. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA201803029.htm
[7]	苏宁, 孙婷婷, 温素礼, 等. 内科护士的误吸评估预防工作情况调查分析[J]. 中国妇幼健康研究, 2017, 28(S2): 324-325. https://www.cnki.com.cn/Article/CJFDTOTAL-SANE2017S2361.htm
[8]	曹娟, 王燕萍, 任浩翡, 等. 老年人误吸风险评估量表的临床应用[J]. 解放军护理杂志, 2017, 34(20): 69-71. doi: 10.3969/j.issn.1008-9993.2017.20.017
[9]	阮顺莉, 陈茜. 常见吞咽障碍筛查工具应用进展[J]. 医学综述, 2018, 24(2): 316-320. doi: 10.3969/j.issn.1006-2084.2018.02.020
[10]	王红, 柏慧华, 高燕芬, 等. Gugging吞咽功能评估表筛查在神经外科术后患者首次进食中的应用[J]. 护士进修杂志, 2019, 34(6): 547-549. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX201906020.htm
[11]	张红霞, 周建妹. 住院老年患者误吸发生率及危险因素的调查[J]. 老年医学与保健, 2017, 23(6): 570-571, 579. doi: 10.3969/j.issn.1008-8296.2017.06.036
[12]	汪晔, 俞计明, 潘银芳. 吸入性肺炎60例临床诊治分析[J]. 浙江医学, 2016, 38(6): 418-420. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201606015.htm
[13]	陶胜茹, 蔡兴东, 杨艳丽. 住院患者误吸危险因素评估量表的设计和应用[J]. 广东医学, 2016, 37(13): 1960-1962. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201613018.htm
[14]	詹燕, 江力, 叶习红, 等. 强化呼吸训练在老年卒中后吞咽障碍康复中的应用效果分析[J]. 中华全科医学, 2017, 15(5): 735-737. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201705003.htm
[15]	赵琛, 于圆圆, 王旭惠, 等. 高龄老年患者吞咽障碍及误吸的筛查及临床特点[J]. 中国康复, 2020, 35(3): 150-152. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLKF202003013.htm
[16]	俞帆, 柏基香, 于咪, 等. 神经外科护理风险管理的影响因素及对策研究[J]. 全科护理, 2017, 15(32): 4077-4078. doi: 10.3969/j.issn.1674-4748.2017.32.049
[17]	王兰珍, 徐利萍, 徐淑芬, 等. 循证视角下脑卒中吞咽障碍患者护理管理方案及效果评价[J]. 中华全科医学, 2021, 19(3): 508-510. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202103049.htm
[18]	姚畑, 杨海燕. 中文版吞咽功能评估量表评估脑卒中患者吞咽障碍的可行性分析[J]. 当代护士(上旬刊), 2016(1): 28-29. https://www.cnki.com.cn/Article/CJFDTOTAL-DDZT201601015.htm
[19]	林丹, 于卫华. 误吸风险评估工具的研究进展[J]. 护理研究, 2013, 27(32): 3601-3603. doi: 10.3969/j.issn.1009-6493.2013.32.008