ABSTRACT
Objective To explore the effects of swallow-feeding management in patients with dysphagia after traumatic brain injury (TBI). Methods By convenient sampling, 53 TBI patients from the Forth Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) from January 2016 to December received a conventional rehabilitation program as the control group. 52 TBI patients from January 2017 to December were recruited into the observation group, while they received the swallow-feeding training and rehabilitation nursing intervention in comparison with the conventional rehabilitation program received in the above control group. The therapeutic effects were evaluated in the two groups through comparing swallowing function pre and post the 30-days interventions, respectively. Results Before intervention the swallowing function of the observation group was graded as grade I (0 example), grade Ⅱ (16 examples), grade Ⅲ (14 examples), grade Ⅳ (14 examples) and grade Ⅴ (8 examples) respectively, while the swallowing function of the control group was graded as gradeⅠ(0 example), gradeⅡ(11 examples), grade Ⅲ(13 examples), gradeⅣ (18 examples) and grade Ⅴ (11 examples) respectively before intervention. The difference in the degrees of the swallowing function had no statistical significance between the control group and the observation group before interventions (Z=-1.268, P=0.205). After intervention the swallowing function of the observation group was graded as grade Ⅰ (20 example), grade Ⅱ (19 examples), grade Ⅲ (10 examples), grade Ⅳ (2 examples) and grade Ⅴ (8 examples) respectively. Meanwhile the swallowing function of the control group was graded as grade Ⅰ (8 example), grade Ⅱ (19 examples), grade Ⅲ (13 examples), grade Ⅳ(10 examples) and grade Ⅴ(3 examples) respectively after intervention. Hence, The difference in the degrees of the swallowing function had statistical significance between the observation group (Z=-6.222, P＜0.01) and control group (Z=-5.892, P＜0.01) pre and post interventions. Moreover, the improvement of swallowing function in the observation group was larger than that of the control group and the difference in the degree of the swallowing function have statistics significance between the two groups (Z=-3.265, P＜0.01). The food intake of the two groups were observed for 30 days, and the results revealed that there were 1 502 cases and 808 cases in respiratory aspiration in the control group and observation group respectively. It can be seen that the incident rate of respiratory aspiration was significantly lower in the observation group than that of the control group (χ2=52.567, P=0.047). Conclusion The Swallow-feeding management can improve the swallowing function, effectively reduce the incidence of respiratory aspiration and also enhance the quality of life in TBI patients.