Department C, University Hospital of Copenhagen, Gentofte Hospital, Denmark.
J Neurosci Nurs. 2013 Jun;45(3):139-46. doi: 10.1097/JNN.0b013e31828a412c.
Dysphagia occurs in approximately 51%-78% of patients with acute stroke. The incidence of pneumonia caused by aspiration in dysphagic patients increases both mortality and the need for hospitalization. The aim of this study was to investigate whether the incidence of aspiration pneumonia could be reduced in such patients by an early screening for dysphagia and intensified oral hygiene.
In this controlled trial, 146 hospitalized acute stroke patients with moderate or severe dysphagia were included in three groups: an intervention group (n = 58), one internal control group (n = 58, retrospectively selected from same clinic), and one external control group (n = 30) from a comparable stroke unit in a neighboring hospital. The intervention consisted of early screening with a clinical method of dysphagia screening, the Gugging Swallowing Screen, and intensified oral hygiene.
The incidence of x-ray verified pneumonia was 4 of 58 (7%) in the intervention group compared with 16 of 58 (28%) in the internal control group (p < .01) and with 8 of 30 (27%) in the external control group (p < .05).
Early and systematic dysphagia screening by the Gugging Swallowing Screen method and intensified oral hygiene reduced the incidence of x-ray verified pneumonia.
约 51%-78%的急性脑卒中患者会出现吞咽困难。吞咽困难患者发生吸入性肺炎的发病率增加，死亡率和住院需求也随之增加。本研究旨在探讨通过早期吞咽困难筛查和加强口腔卫生护理，能否降低此类患者的吸入性肺炎发生率。
在这项对照试验中，将 146 名中度或重度吞咽困难的住院急性脑卒中患者分为三组：干预组（n = 58）、内部对照组（n = 58，从同一诊所回顾性选择）和外部对照组（n = 30），分别来自附近医院的可比卒中单元。干预措施包括使用临床吞咽困难筛查方法（Gugging 吞咽筛查）进行早期筛查和加强口腔卫生护理。
干预组 X 射线证实肺炎的发生率为 4/58（7%），内部对照组为 16/58（28%）（p<.01），外部对照组为 8/30（27%）（p<.05）。
通过 Gugging 吞咽筛查方法进行早期和系统的吞咽困难筛查，并加强口腔卫生护理，可降低 X 射线证实肺炎的发生率。
