The Application Of GUSS Swallowing Function Screening Combined With Ingestion Training In Patients With Dysphagia After Stroke

Objective: To explore the effect of guss swallowing function screening combined with ingestion training on the recovery of swallowing function,the time of gastric tube retention,the rate of gastric tube removal,the incidence of aspiration pneumonia,nutritional status and the quality of life of swallowing in patients with dysphagia after stroke,so as to make up for the deficiency of swallowing and ingestion management,and provide reference for the standardization of clinical nursing work of dysphagia after stroke.Methods: From January to October 2019,84 stroke patients with dysphagia who were hospitalized in the Department of Neurology of Ruikang Hospital Affiliated to Guangxi University of traditional Chinese medicine and met the inclusion criteria were selected as the study objects.The control group(n= 42)was given routine nursing of swallowing disorders in neurology department,including intermittent oral to esophageal feeding,diet guidance,oral care,health education,psychological care,etc;the observation group(n= 42)was given guss swallowing function screening combined with ingestion training on the basis of the control group,including guss swallowing function screening,auxiliary swallowing training,adjustment of eating position,compensatory swallowing,quantification of food characteristics and one mouthful quantity,eating monitoring and follow-up.In this study,SPSS 20.0 software was used for data entry and statistical analysis.The measurement data in the two groups were compared by twoindependent samples t-test,which was expressed by mean soil standard deviation;the count data was expressed by rate or percentage,which was expressed by chi square test or continuous correction chi square test;the rank sum test was used for rank data comparison,P < 0.05,which was statistically significant.Before and after the intervention,the recovery of swallowing function,the extraction rate of gastric tube,the retention time of gastric tube,the incidence of aspiration pneumonia,nutritional status and quality of life were evaluated.Results: 1.Comparison of baseline data: There was no significant difference between the two groups in age,gender,education level,main caregivers,medical payment mode,stroke type,course of disease,NIHSS score,lesion location,swallowing status of water swallow test(P > 0.05).The baseline of the two groups was consistent and comparable.2.Comparison of swallowing function recovery: after the intervention,the total effective rate of swallowing function recovery in the observation group was 90.00%(36 / 40)significantly higher than 67.50%(27/40)in the control group,the difference was statistically significant(P < 0.05).3.Comparison of gastric tube extraction rate and gastric tube retention time: after the intervention,the gastric tube extraction rate in the observation group was 68.00%(17 / 25)significantly higher than that in the control group 20.83%(5 / 24),with a statistically significant difference(P < 0.05);the gastric tube retention time in the observation group(17.40 ± 2.62)was significantly shorter than that in the control group(24.50 ± 2.99),with a statistically significant difference(P < 0.05).4.Comparison of the incidence of aspiration pneumonia: 28 days after intervention,the incidence of aspiration pneumonia in the observation group was 2.50%(1 / 40)lower than that in the control group 12.50%(5 / 40),but the difference was not statistically significant(P > 0.05).5.Nutritional status comparison: the results showed that there was no significant difference in BMI,HB,ALB and TP between the two groups before treatment(P > 0.05),which was comparable;after treatment,HB,ALB and TP in the observation group(122.65 ± 9.56,38.50 ± 2.46,63.45 ±2.42)were significantly better than those in the control group(116.10 ± 9.62,36.50 ± 2.76,60.50 ± 2.89),which was statistically significant(P <0.05).There was no significant difference in BMI between the observation group(19.80 ± 1.51)and the control group(P > 0.05).6.Comparison of swallowing quality of life: there was no significant difference in swallowing quality of life between the two groups before treatment(P > 0.05),which was comparable;after treatment,the observation group patients' psychological burden,eating time,eating desire,symptom frequency,food selection,fear,mental health and social interaction(6.05 ± 0.95,7.00 ± 0.64,10.50 ± 1.24,54.85 ± 3.31,8.30 ± 0 73,12.60 ± 1.14,17.15 ± 2.94)were significantly better than the control group(4.45±0.61,5.25±0.64,7.65±1.39,41.15±3.15,6.55±0.61,11.40±0.10,14.20±1.15,8.50±0.61),the difference was statistically significant(P <0.05),but there was no significant difference in language communication,sleep and fatigue(P > 0.05).Conclusion: Guss swallowing function screening combined with ingestion training can effectively improve the recovery rate of swallowing function of patients with dysphagia after stroke,improve the extraction rate of gastric tube,shorten the retention time of gastric tube,reduce the incidence of aspiration pneumonia and malnutrition,which has a positive effect on the prevention of adverse outcomes and the improvement of patients' quality of life,and is worthy of clinical application.