[目的]探讨基于标准吞咽功能评估的分层干预对脑卒中吞咽障碍患者吞咽功能及营养状况的影响.[方法]选择2015年1月至2017年12月本院收治的脑卒中吞咽障碍患者96例为研究对象,随机分为观察组和对照组各48例.对照组给予脑卒中吞咽障碍患者常规护理干预及康复训练,观察组给予基于吞咽功能评估下的分层护理干预及康复训练.干预4周后,比较两组吞咽功能、营养状况、并发症等指标.[结果]观察组患者吞咽功能优良率明显高于对照组(P<0.05);血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)含量明显高于对照组(P<0.05);误吸、吸入性肺炎等并发症发生率明显低于对照组(P<0.05).[结论]基于标准吞咽功能评估的分层干预有助于恢复脑卒中吞咽障碍患者吞咽功能,改善患者营养状况,预防误吸、吸入性肺炎等并发症的发生.

Objective To investigate temperature management and nursing strategies for patients with acute ischemic stroke ( AIS).Methods A total of 118 patients with AIS in Huai′an First People′s Hospital, Nanjing Medical University were enrolled in the study.They were randomly divided into two groups.Routine nursing was performed in control group (58 cases), and temperature management with nursing intervention was performed in research group (60 cases).Results The compliance rate of treatment and satisfaction degree of nursing in research group were significantly higher than those in control group (P<0.05).After nursing, temperature of research group was significantly lower than that of control group (P<0.05).FIM score and Barthel score of research group were significantly higher than those of control group (P<0.05).Conclusions Temperature management with nursing intervention for patients with AIS can improve treatment compliance and enhance nursing quality and quality of life.

A total of 218 outpatients with first-episode and high-risk ischemic strokes were randomly divided into management and control groups.Management group received multidisciplinary disease care mode while control group common disease care mode.The results showed that the functional independent measures (FIM) score of management group improved dramatically (89 ± 28 vs.81 ± 26,P =0.04).The National Institutes of Health Stroke Scale (NIHSS) score changed significantly (13.9 ± 5.6 vs.16.1 ± 6.9,P =0.02).Systolic blood pressure significantly changed [(131 ± 17) vs.(137 ±23) mmHg(1 mmHg =0.133kPa),P=0.04].Diastolic blood pressure significantly changed [(81 ± 10) vs.(85 ± 15) mmHg,P =0.03] ; Low density lipoprotein decreased [(2.54 ± 0.75) vs.(2.81 ± 0.65) mmol/L,P =0.01].The number of readmitted patients also decreased significantly (P =0.04).Thus muhidisciplinary disease care mode could enhance the qualityof-life,control risk factors and improve patient prognosis.

目的:应用长效物理抗菌功能的洁悠神喷洒在尿管留置的卒中患者的尿道口及尿管表面,观察其对留置导尿管伴随性尿路感染(CAUTI)的发生率的影响。方法:将我科100例脑卒中后留置导尿管的患者,年龄40～85岁,随机分为对照组50例和实验组50例。对照组,按常规行尿道口护理,2次/天;实验组,按常规行尿道口护理后,加用洁悠神喷洒于导尿管壁及尿道口,2次/天。结果:实验组脑卒中患者发生尿路感染的病例数明显低于对照组,差异有统计学意义(χ2=21.42,P<0.01)。结论:对留置导尿管的卒中患者使用洁悠神喷洒导尿管表面和尿道口,可形成一层物理抗菌分子膜,阻止细菌生物膜的形成,能有效降低卒中后尿路感染的发生。

压疮是脑血管病的常见并发症之一，也是护理工作中较为棘手的问题，它不仅导致病人住院日数的增长，医疗费用增加，而且可影响脑血管疾病的治疗效果。