标准吞咽功能评价量表在吞咽障碍患者胃管拔管时机中的应用

摘要

目的 探讨标准吞咽功能评价量表(standardized swallowing assessment,SSA)在吞咽障碍患者胃管拔管时机中的应用效果.方法 2013年1月~2014年12月选取本科室鼻饲留置胃管吞咽障碍患者100例,采用简单数字随机法分为观察组和对照组,每组各50例.对照组患者给予常规护理及误吸知识预防宣教,根据医嘱拔除胃管.观察组患者每周应用SSA评价量表进行吞咽功能及误吸风险评估,根据患者吞咽功能恢复情况及误吸风险评分,采取针对性功能锻炼及确定拔管时机.比较两组患者拔除胃管后再次置管及吸入性肺炎的发生率.结果 两组患者再次置管及吸入性肺炎发生率比较,均P<0.01,差异具有统计学意义,观察组患者发生率明显低于对照组.结论 对鼻饲吞咽障碍患者使用SSA评价量表进行吞咽功能及误吸风险评估,根据患者误吸风险评分实施针对性功能锻炼,并确立拔管时机,可以有效降低患者再次置管及吸入性肺炎发生率.%Objective To explore the effect of the standardized swallowing assessment (SSA) on extubation time for patients with nasal feeding. Methods One hundred patients with nasal feeding in our department from January 2013 to December 2014 were divided into the observation group and control group randomly with 50 in each group. The control group was treated with education on aspiratioin prevention and the right time for extubation was decided following doctor′s order. SSA was used in the observation group with weekly SSA and swallowing function, then the patients took pertinent functional exercises till a right time for extubation was decided. The two groups were compared in terms of incidences of re-intubation and aspiration pneumonia. Result The observation group had significantly lower incidences of re-intubation and aspiration pneumonia than the control one (P<0.01). Conclusions SSA is used to assess the swallowing function as well as the aspiration risks , which helps patients to take functional exercise and helps nurses to decide the right time for extubation. It can effectively lower the incidences of re-intubation and aspiration pneumonia and improve patients′prognosis.