Objective To explore the application value of multidimensional rehabilitation management mode in patients with dysphagia after stroke. Methods A total of 66 patients with dysphagia after stroke in Shanghai Ruijin Rehabilitation Hospital between December 2019 and October 2021 were selected as the subjects. In the control group, 35 cases were from the comprehensive rehabilitation ward, and the routine comprehensive rehabilitation intervention program was adopted. In the observation group, 31 cases were from the encephalopathy rehabilitation ward. On the basis of the control group, the multidimensional rehabilitation management mode including multidisciplinary collaboration, risk management and delicacy management was used for intervention. The swallowing function of both groups was evaluated respectively by Sub-water Test Score, Videofluoroscopic Swallowing Study (VFSS) and Penetration Aspiration Scale (PAS) before and after the 3 weeks' intervention. The functional level of intake of food and liquid was evaluated by Functional Oral Intake Scale (FOIS). Nutritional status was assessed by measuring serum albumin level. The Chinese version of Swallowing-Quality of Life(SWAL-QOL) was used to assess the quality of life. Results The total effective rate in the observation group was 87.1% (27/31), higher than that in the control group 64.6% (26/35), the difference was statistically significant (χ2 =6.150, P < 0.05). After the intervention, the VFSS and FOIS scores of the 2 groups were higher than before (P < 0.05). After the intervention, the VFSS score of the observation group was higher than that of the control group[ (8.32±1.28) vs (7.03±1.98) points]. After the intervention, the FOIS score of the observation group was higher than that of the control group [5.0(4.0,6.0) vs 3.0(1.0,6.0) points], and the difference was statistically significant (t=3.260, Z=-3.196; all P < 0.01). After the intervention, the PAS score of the observation group was lower than that of the control group [1.0 (1.0,1.0) vs 2.0 (1.0, 5.0) points], and the difference was statistically significant (Z=-2.429, P<0.05). The serum albumin level in the observation group after the intervention was higher than that before intervention [(33.44±3.19) vs (30.90±3.34)g/L], and the difference was statistically significant (t=6.528, P < 0.01). The scores of SWAL-QOL in Chinese version of the two groups were higher than those before the intervention, and after the intervention, the score of observation group was higher than that of control group [135.0 (129.0,149.0) vs 103.0 (94.0,136.0) points], and the difference was statistically significant (Z=-3.023, P < 0.01). Conclusions Multidimensional rehabilitation management mode has a positive effect on ensuring the nutritional needs of patients with dysphagia after stroke, improving swallowing function and providing quality of life.
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雷茵,顾琳,严琳,徐涵,高怡,武军.多维度康复管理模式在卒中后吞咽障碍患者 康复中的应用[J].神经疾病与精神卫生,2023,23(8): DOI :10.3969/j. issn.1009-6574.2023.08.007.