Application of individualized nutritional intervention based on screening of dysphagia in postoperative patients with cerebellopontine angle occupying lesion / 中国实用护理杂志

ABSTRACT

Objective@#To explore the effect of individualized nutrition intervention mode based on dysphagia screening in postoperative patients with cerebellopontine angle occupying lesion.@*Methods@#By developing nurses training, selecting special screening and evaluation tools, developing screening methods and individualized nutrition intervention measures and meal spectrum, making screening and intervention flow chart, and starting to be implemented in postoperative patients with cerebellopontine angle occupying lesion in July 2017. Forty-six patients with cerebellopontine angle occupying lesion in the previous year were reviewed as the control group, who were given routine treatment and nursing; One year after implementation, Another 48 patients were set as the experimental group, and were given individualized nutritional care based on screening of dysphagia.@*Results@#The incidence rate of dominant aspiration(0), pneumonia (4.17%, 2/48) and diarrhea (2.08%,1/48) in the experimental group was lower than 4.35% (2/46), 21.74% (10/46), 19.57% (9/46) in the control group, especially the difference of incidence rate of pneumonia and diarrhea was statistically significant (pneumonia χ2=0.010, P=0.013; diarrhea χ2=0.006, P=0.007). The retention rate of gastric tube in the experimental group (31.30%, 18/48) was lower than that in the control group (58.70%, 27/46), the difference was statistically significant (χ2=7.158, P=0.007). Average retention time of gastric tube in the experimental group (4.47±1.13) d was less than that in the control group (5.11±0.70) d, the difference was statistically significant (t=2.296, P=0,027). The hospitalization time in the experimental group (8.69±1.36) d were less than those in the control group (12.57±2.95) d, the difference was statistically significant (t=8.248, P=0,000). The nutritional status of 7 days after operation of the experimental group was better than that of the control group, the differenc e was statistically significant (albumin t=4.888, P<0.01; prealbumin t=5.188, P<0.01; hemoglobin t=4.039, P<0.01). The knowledge and skills of swallowing of general nurses improved significantly after the work, in particular, the accuracy of screening tests for Wa Tian drinking water increased from 5/8 to 20/20. The difference was statistically significant (χ2=8.148, P=0.017).@*Conclusions@#Individualized nutrition intervention based on screening for dysphagia can improve the clinical outcome of patients, improve the comprehensive ability of nurses and achieve a win-win situation of nurse - patient.