The Clinical Research On Dysphagia,Nutritional State Assessment And Nutritional Support Treatment Of Stroke Patients

Part1 The clinical research on evaluation of swallowing function and imaging appearance of stroke patients in hospital[Objective]:dysphagia is the common symptome of stroke patients,according to different literature report,dysphagia is appeared in 22%～65%of stroke patients,but in clinical there is not direction treatment to those patients,so that misses the best treatment opportunity,and the recovery time of dysphagia has to lengthen greatly. The traditional viewpoint thought that the appearance of dysphagia after stroke is because the damage of the brain stem or the two-sided cerebral hemisphere,but more and more literature report that each spot damage may cause to dysphagia.This research is further clear about the incidence rate of dysphagia in stroke;combining with imageology,analysis the incidence rate and mechanism of dysphagia in different damaged spot;the incidence rate of dysphagia after conventional stroke treatment;the influence of stroke history to the incidence rate of dysphagia.[Methods]:Select 320 cases of stroke patients hospitalized in the stroke unit of neurology department in our hospital,based on the patients whether there is a history of stroke is divided into two groups,the first stroke group has 147 cases of stroke patients,non-first stroke group that is the past history of stroke group has 173 cases.All consciousness clear patients separately after in hospital in 24h and the convention treatment 2weeks later were evaluated the swallow function by water drinking test,water drinking test≥3 level and the patients with conscious disturbance thought that is accompanied by swallows the function to be unusual.Admission and treatment for two weeks after the two groups of patients with dysphagia statistics; stroke damage to different parts of dysphagia rate statistics.[Results]:320 cases with 113 cases exist in dysphagia,up 35.31 percent,two weeks after conventional treatment,there are still 33 cases of patients with dysphagia,to 10.31 percent.The incidence rate of dysphagia of different damage parts is not the same.Of the two groups of patients,the first stroke group was 28.57 percent of the incidence rate of dysphagia,and a past history of stroke patients to 41.04 percent,a significant difference.[Conclusion]:The incidence rate of dysphagia after stroke is higher,especially in the patients of stroke history,each spot suffers injury may appear dysphagia,the incidence rate is different,becomes the head by the medulla and multiple bilateral hemisphere disease,the conventional drug treatment can not bring all Patients with swallowing function have been restored,dysphagia patients respond to targeted therapy.Part2 The clinical research of assessing the nutritional status of stroke patients[Objective]:The incidence rate of dysphagia after stroke is higher,but not in clinical attention.Reported in the literature,the dystrophy incidence rate after stroke is about 15%,while a week later increased to 30%.Dystrophy will lead to poor prognosis,delaying the rehabilitation of patients.This study further defined the malnutrition rate of stroke patients and the impact of history of stroke on the nutritional status of stroke patients.[Methods]:Select 320 cases of stroke patients hospitalized in the stroke unit of neurology department in our hospital,based on the patients whether there is a history of stroke is divided into two groups,the first stroke group has 147 cases of stroke patients,non-first stroke group that is the past history of stroke group has 173 cases. All the patients in the hospital within 24h after the relevant nutritional index measurement,assessment of the two groups in the incidence of malnutrition.[Results]:Stroke patients with high incidence of malnutrition,320 patients through nutrition assessment,a total of 111 cases of patients with malnutrition,up 34.69 percent,the first stroke group of which 23.13 percent for stroke patients,and a previous history of stroke patients to 44.51 percent,and two groups of patients with nutritional indicators are significant differences.[Conclusion]:Stroke patients with high incidence of malnutrition,clinicians in routine treatment of stroke should also pay greater attention to the nutritional status of stroke patients,especially with the past history of stroke patients,the patients with existence of nutritional disorder should be given the appropriate treatment promptly to Reduce complications and improve the prognosis.Part3 The clinical research of nutritional support treatment on stroke patients with dysphagia[Objective]:Stroke patients have the high incidence of malnutrition,large FOOD tests showed that malnutrition is the independent risk factor lead to bad result of stroke.Therefore,give a reasonable nutrition support to the malnutrition stroke patients is of great significance.This study further clear the impact of different nutritional support of malnutrition indicators of nutrition,treatment and complications;the treatment effect of different nutritional support on the coma patients.[Methods]:Select 113 cases of stroke patients hospitalized in the stroke unit of neurology department in our hospital,all patients were assessed by swallowing function,with dysphagia(drinking water test≥3 level)or disturbance of consciousness can not eat normally.Patients were randomly divided into two groups, sequential enteral nutrition therapy group and homogenized feeding group.Two groups of patients on admission and nutritional support for 21 d were recorded TSF, AMC,Hb,ALB,PA,at the same time observe the infection rate of complications (including lung infections,gastro-intestinal infections,urinary tract infections and bed sores)and clinical(NIHSS Score)changes,in comatose patients resume a clear record of the time. 【Results】:After the sequential treatment of enteral nutrition therapy group nutrition indicators were higher than the homogenized group meal,infection complication rate lower than the homogenized group meal,clinical efficacier than homogenate feeding group,coma patients resume a shorter time in homogenate feeding group,and the differences were statistically significant.【Conclusion】:With the stroke of malnutrition in patients with conventional treatment for early stage at the same time,reasonable enteral nutrition therapy, patients can improve the nutritional indicators,reduce the incidence of infection complications,promote the neurological recovery,improve the clinical efficacy, Comatose patients a role in promoting smarter.