Analysis of the application effect of staged functional training in dysphagia in stroke patients undergoing tracheotomy
分阶段功能训练在脑卒中气管切开患者吞咽障碍中的应用效果分析

摘要

目的 分析康复护理措施对脑外伤气管切开术后吞咽障碍患者吞咽功能恢复、营养状况及并发症发生情况的应用效果。方法 选取2024年1月至2025年1月在我院接受治疗的40例脑外伤气管切开术后吞咽障碍患者作为研究对象，采用随机数字表法分为对照组和实验组，各20例。对照组实施常规护理干预，实验组在常规护理基础上采用针对性康复护理措施。比较两组患者护理前后的吞咽功能分级（洼田饮水试验）、营养指标[血清白蛋白（ALB）、前白蛋白（PA）]及并发症（肺部感染、误吸、营养不良）发生情况。结果 护理前，两组患者洼田饮水试验分级、ALB及PA水平比较，差异无统计学意义（P>0.05）；护理后，实验组洼田饮水试验Ⅰ级占比（65.00%）高于对照组（30.00%），Ⅳ-Ⅴ级占比（5.00%）低于对照组（35.00%），差异有统计学意义（P<0.05）；实验组ALB（38.56±2.34g/L）、PA（225.34±18.56mg/L）水平高于对照组（34.23±2.15g/L、186.78±16.32mg/L），差异有统计学意义（P<0.05）。实验组并发症总发生率（10.00%）低于对照组（45.00%），差异有统计学意义（P<0.05）。结论 对脑外伤气管切开术后吞咽障碍患者实施康复护理措施，可有效促进其吞咽功能恢复，改善营养状况，降低并发症发生率，具有较高的临床应用价值。

Abstract

Objective To analyze the application effect of rehabilitation nursing measures on the recovery of swallowing function, nutritional status and the occurrence of complications in patients with dysphagia after tracheotomy for brain trauma.
Methods Forty patients with dysphagia after tracheotomy for brain trauma who were treated in our hospital from January 2024 to January 2025 were selected as the research subjects. They were divided into the control group and the experimental group by random number table method, with 20 cases in each group. The control group received conventional nursing intervention, while the experimental group adopted targeted rehabilitation nursing measures on the basis of conventional nursing. The swallowing function classification (Wada drinking water test), nutritional indicators [serum albumin (ALB), prealbumin (PA)] and the occurrence of complications (pulmonary infection, aspiration, malnutrition) of the two groups of patients before and after nursing were compared.
Results Before the nursing care, there was no statistically significant difference in the classification of the Wada drinking water test, ALB and PA levels between the two groups of patients (P>0.05). After the nursing care, the proportion of grade I in the Wada drinking water test in the experimental group (65.00%) was higher than that in the control group (30.00%), and the proportion of grade IV - V (5.00%) was lower than that in the control group (35.00%), and the difference was statistically significant (P<0.05). The levels of ALB (38.56±2.34g/L) and PA (225.34±18.56mg/L) in the experimental group were higher than those in the control group (34.23±2.15g/L, 186.78±16.32mg/L), and the difference was statistically significant (P<0.05). The total incidence of complications in the experimental group (10.00%) was lower than that in the control group (45.00%), and the difference was statistically significant (P<0.05).
Conclusion   Implementing rehabilitation nursing measures for patients with dysphagia after tracheotomy for brain trauma can effectively promote the recovery of their swallowing function, improve their nutritional status, and reduce the incidence of complications, which has high clinical application value.