洼田饮水试验和Gugging吞咽功能评估量表在老年亚急性脑出血患者中的应用价值

发布时间：2018-03-22 08:25

本文选题：GUSS评估量表　切入点：洼田饮水试验　出处：《中国老年学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨洼田饮水试验和Gugging吞咽功能(GUSS)评估量表在老年亚急性脑出血患者中的应用价值。方法选取老年亚急性期脑出血伴吞咽困难的患者200例,给予NRS-2002评估表进行营养评定。患者均同时采用洼田饮水试验和GUSS量表评估吞咽困难,即实施间接吞咽测试和直接吞咽测试,根据筛查结果制定相应的饮食及营养指导,在入院1个月、3个月和6个月均检查吸入性肺炎和营养不良发生情况。通过效应值、标准化的反应平均值以Wilcoxon符号秩和检验洼田饮水试验和GUSS评估量表的反应性。结果 GUSS评估量表比洼田饮水试验对于吞咽障碍检出级别更高(P0.05)。根据GUSS筛查结果对患者采取相关治疗和护理措施以干预吞咽困难,26例(13.0%)患者发生吸入性肺炎,31例(15.5%)患者发生营养不良,患者住院时间为(17.21±3.21)d。患者经过治疗体重显著增加(t=2.840,P0.05),生活质量显著提高(t=20.871,P0.05)。患者均完成治疗前后的评估,结果显示2种评估量表的反应性均较好,GUSS评估量表反应性高于洼田饮水试验(P0.05)。结论对老年亚急性脑出血患者及早采用GUSS评估量表进行吞咽障碍筛查,可以为临床早期评估提供临床证据,并据此给予针对性饮食指导,可有效降低不良反应发生率,改善患者生活质量。
[Abstract]:Objective to investigate the application value of Wata drinking water test and Gugging swallowing function evaluation scale in elderly patients with subacute intracerebral hemorrhage. Methods 200 cases of senile subacute cerebral hemorrhage with dysphagia were selected. The patients were evaluated for dysphagia by both the depressions drinking water test and the GUSS scale, that is, indirect and direct swallowing tests were carried out, and the corresponding dietary and nutritional guidelines were formulated according to the screening results. The incidence of aspiration pneumonia and malnutrition were examined at 1 month, 3 months and 6 months after admission. The standardized response average was tested by Wilcoxon symbolic rank sum to test the reactivity of the sag drinking water test and the GUSS evaluation scale. Results the GUSS evaluation scale was higher than the Okuda drinking water test in the detection of dysphagia (P 0.05). According to the results of GUSS screening, Patients with dysphagia were treated with relevant treatment and nursing measures to interfere with dysphagia in 26 patients with dysphagia (13. 0) and 31 patients with aspiration pneumonia (31 / 15. 5) patients suffered from malnutrition. The hospitalization time of the patients was 17.21 卤3.21 days. After treatment, the weight of the patients increased significantly, and the quality of life significantly improved. The patients completed the evaluation before and after treatment. The results showed that the reactivity of the two evaluation scales was better than that of the Wata drinking water test (P 0.05). Conclusion the GUSS evaluation scale is used to screen for dysphagia in elderly patients with subacute intracerebral hemorrhage as early as possible. It can provide clinical evidence for early clinical evaluation and provide targeted dietary guidance, which can effectively reduce the incidence of adverse reactions and improve the quality of life of patients.
【作者单位】：华中科技大学同济医学院附属普爱医院神经外科;
【基金】：武汉市卫计委科研基金项目(WZ16C17)
【分类号】：R743.34

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