心脏术后获得性吞咽障碍患者吞咽功能恢复时间及影响因素研究

doi:10.3761/j.issn.0254-1769.2020.09.011

摘要/Abstract

摘要：

目的探讨心脏术后获得性吞咽障碍患者吞咽功能恢复时间及影响因素，为优化其康复方案提供参考。方法选取2018年10月—2019年10月就诊于南京市某三级甲等医院的85例心脏术后获得性吞咽障碍患者为研究对象，收集患者一般资料和临床相关资料，以吞咽功能恢复结局及恢复时间为因变量，采用Kaplan'Meier法和Cox比例风险回归分析吞咽功能恢复时间及其影响因素。结果心脏术后获得性吞咽障碍患者吞咽功能恢复时间为1~12（2.72±1.85） d。多因素Cox比例风险回归分析结果显示，气管插管时间（RR=0.987，P=0.004）和拔管后首次标准吞咽功能评估量表评分（RR=0.828，P＜0.001）影响心脏术后获得性吞咽障碍患者的吞咽功能恢复时间。结论气管插管时间和拔管后首次标准吞咽功能评估量表评分是心脏术后获得性吞咽障碍患者吞咽功能恢复的影响因素，尚需进一步明确吞咽障碍恢复进程及相关预后指标，从而优化临床实践，改善患者预后结局。

关键词: 心脏外科手术, 获得性吞咽障碍, 恢复时间, 影响因素, 护理

Abstract:

Objective To explore the recovery time of swallowing function and its influencing factors in patients with acquired swallowing disorder after cardiac surgery,so as to provide references for optimizing the rehabilitation program of acquired dysphagia.Methods A total of 85 patients with acquired swallowing disorders after cardiac surgeries who were admitted to a tertiary hospital in Nanjing from October 2018 to October 2019 were selected;demographic and clinical data was collected;the outcome and recovery time of swallowing function were the dependent variables;Kaplan-Meier method and Cox proportional hazards model were used to analyze the recovery time of swallowing function and its influencing factors.Results The recovery time of swallowing function in patients with acquired dysphagia after cardiac surgeries was 1-12 days,and the mean recovery time was 2.72±1.85 days. Cox proportional hazards analysis indicated that endotracheal intubation time（RR=0.987,P=0.004） and the first standardized swallowing assessment score （RR=0.828,P<0.001） after extubation had a significant impact on the recovery time of swallowing function in patients with acquired swallowing disorder after cardiac surgeries.Conclusion Endotracheal intubation time and the first standardized swallowing assessment score after extubation are independent influencing factors for the recovery of swallowing function in patients with acquired swallowing disorder after cardiac surgeries. In the future,it is still necessary to further clarify the recovery process of dysphagia and related prognostic indicators,so as to optimize the clinical practice and improve the prognosis of patients.

Key words: Cardiac Surgery, Acquired Dysphagia, Recovery Time, Influencing Factors, Nursing Care

余金甜,陈俊杉,张爱琴. 心脏术后获得性吞咽障碍患者吞咽功能恢复时间及影响因素研究[J]. 中华护理杂志, 2020, 55(9): 1341-1345.

YU Jintian,CHEN Junshan,ZHANG Aiqin. Study on recovery time and influencing factors of swallowing function in patients with acquired dysphagia after cardiac surgery[J]. Chinese Journal of Nursing, 2020, 55(9): 1341-1345.

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