目的 探讨不同床边吞咽功能评估方法对脑卒中伴吞咽障碍患者吸入性肺炎发生率及营养状况的影响.方法 选择2010年1-12月入住本院神经内科的80例急性缺血性脑卒中伴吞咽障碍患者,随机分为两组,一组采用简单的床边吞咽功能评价工具(GUSS)进行评估,另一组采用洼田饮水试验进行评估,根据评定结果制定相应的饮食策略,比较两组吸入性肺炎的发生率及血清前清蛋白(PA)水平.结果 入院第3、7天,两组患者吸入性肺炎的发生率比较,差异均无统计学意义(P＞0.05),而第14天两组比较差异有统计学意义(P＜0.05).入院第1天两组血清PA水平比较,差异无统计学意义(P＞0.05);而第14天两组比较差异有统计学意义(P＜0.05).结论 GUSS评估方法及饮食策略能降低吸入性肺炎的发生率,改善营养状况,对脑卒中患者的康复起到一定的积极作用.%Objective To evaluate the effect of different bedside evaluations of deglutition function on aspiration pneumonitis and nutritional condition in patients with stroke combined with deglutition disorders. Methods 80 patients with acute is-chemic stroke combined with deglutition disorders admitted to the Department of Neurology of our hospital were randomly divided into two groups, with one group evaluated by GUSS and the other group evaluated by Water Drinking Test. Diet strategy was established according to the results of evaluation. The incidence of aspiration pneumonitis and prealbumin ( PA ) were compared between the two groups. Results The incidence of aspiration pneumonitis showed no statistically significant difference between the two groups on the third day and seventh day after admission ( P > 0. 05 ) . But the incidence showed statistically significant difference on the 14th day after admission ( P < 0. 05 ) . The levels of PA showed no statistically significant difference between the two groups on the first day after admission ( P > 0. 05 ), but showed statistically significant difference on the 14th day after admission ( P < 0. 05 ) . Conclusion GUSS evaluation and diet strategy can reduce the incidence of aspiration pneumonitis and improve nutritional condition, and it can play a positive role in the recovery of patients with stroke.
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