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洼田饮水试验在多发性肌炎和皮肌炎吞咽功能评估中的应用

Application of water swallow test in evaluation of swallowing function of polymyositis and dermatomyositis

摘要目的:探讨洼田饮水试验在多发性肌炎(PM)和皮肌炎(DM)吞咽功能评估中的应用。方法:选取2018年5月至2019年5月惠州市中心人民医院风湿科收治的PM/DM患者64例进行回顾性分析。根据患者接受护理方式的不同将其分为两组:其中对照组32例予常规护理,观察组32例应用洼田饮水试验评估吞咽功能及早期护理干预,比较两组患者的住院时间、营养状况、护理满意度及并发症发生情况。结果:观察组住院时间明显短于对照组,差异有统计学意义( P<0.05)。护理前两组患者营养状况比较差异无统计学意义( t=-0.092, P>0.05),护理后观察组营养状况得分明显高于对照组( t=-3.089, P<0.05)。观察组护理满意度得分明显高于对照组( t=-3.946, P<0.05),观察组误吸率及吸入性肺炎发生率分别为9.38%、6.25%,明显低于对照组的34.38%、25.00%,差异均有统计学意义( χ2=5.851,4.267;均 P<0.05)。 结论:应用洼田饮水试验对多发性肌炎和皮肌炎的患者进行吞咽功能评估,及早发现吞咽功能障碍,进行针对性的护理干预,能明显缩短住院时间,改善患者营养状态,预防营养不良,降低误吸、吸入性肺炎等并发症的发生率,提高护理满意度。

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abstractsObjective:To investigate the application of water swallow test in the evaluation of swallowing function of polymyositis (PM) and dermatomyositis (DM).Methods:A retrospective analysis was conducted on 64 PM/DM patients admitted to the rheumatology department of the hospital from May 2018 to May 2019.Patients were divided into two groups according to the way they received care.A total of 32 patients in the control group received routine nursing, and 32 patients in the observation group received drinking water test to evaluate swallowing function and early nursing intervention.The hospitalization time, nutritional status, nursing satisfaction and complications of the two groups were compared.Results:The hospital stay in the observation group was significantly shorter than that in the control group, and the difference was statistically significant( P<0.05). There was no significant difference in nutritional status between the two groups before nursing( t=-0.092, P>0.05). After nursing, the score of nutritional status in the observation group was significantly higher than that in the control group( t=-3.089, P<0.05). The scores of nursing satisfaction in the observation group were significantly higher than those in the control group ( t=-3.946, P<0.05). The rate of aspiration and the incidence of aspiration pneumonia in the observation group were 9.38%, 6.25%, respectively, significantly lower than those in the control group (34.38%, 25.00%), and the differences were statistically significant ( χ2=5.851, 4.267; all P<0.05). Conclusions:Used water swallow test of multiple myositis and dermatomyositis patients with swallowing function assessment, early detection swallowing dysfunction, and corresponding nursing intervention, can significantly shorten the length of hospital stay, improve patients' nutrition state, prevent malnutrition, reduce the incidence of complications such as aspiration and aspiration pneumonia, improve nursing satisfaction.

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