标准吞咽功能评估联合容积-黏度吞咽试验在神经外科吞咽障碍患者饮食中的应用
余 鹏 米元元 渠 缘 方 慧 王羡科
华中科技大学同济医学院附属协和医院，湖北 武汉 430000
通信作者：王羡科
【摘要】 目的 探讨标准吞咽功能评估（standardized swallowing assessment，SSA）联合容积-黏度吞咽试验（volume-viscosity swallowing test，V-VST）应用于神经外科吞咽障碍患者喂养管理的效果。方法 采用类实验法，选择神经外科吞咽障碍患者，常规进行 SSA 筛查，将患者分为对照组（n=40）与观察组（n=42）。对照组实施常规护理，根据 SSA 筛查给予营养支持治疗；观察组对于吞咽障碍患者实施标准吞咽功能评估联合容积-黏度吞咽试验筛查，根据筛查结果制定个体化喂养方案。结果 观察组留置胃管率45.24%低于对照组 77.50%（P<0.05），胃管留置时间（7.730.65）d 短于对照组（10.352.26）d（P<0.05），胃管拔管成功率差异无统计学意义（P>0.05），误吸发生率 4.76%低于对照组 20%（P>0.05）。结论 标准吞咽功能评估联合容积-黏度吞咽试验可以精准制定神经外科吞咽障碍患者的饮食方案，降低胃管留置时间，减少误吸发生率确保患者进食安全。
【关键词】 吞咽障碍；标准吞咽功能评估；容积-黏度吞咽试验；饮食指导
【中图分类号】 R473.74 【文献标识码】 A 【文章编号】 1673-5110 （2022） 08-0990-06
DOI：10.12083/SYSJ.220614
Application of standard swallowing assessment combined with volume-viscosity swallowing test in diet of neurosurgical patients with dysphagia
YU Peng，MI Yuanyuan，QU Yuan，FANG Hui，WANG Xianke
Huazhong University of Science and Technology，Union Hospital，Tongji Medical College，Wuhan 430000，China
Corresponding author：WANG Xianke
【Abstract】 Objective To explore the effect of standard swallowing assessment combined with volume-viscosity swallowing test in feeding management of neurosurgical patients with dysphagia. Methods Patients with dysphagia in neurosurgery were selected and screened by SSA routinely. The patients were divided into control group（n = 40）and observation group（n = 42）. The control group was given routine nursing and nutritional support treatment according to SSA screening；the observation group was given standard swallowing function evaluation combined with volume-viscosity swallowing test screening，and individualized feeding plan was made according to the screening results. Results The rate of indwelling gastric tube in the observation group was 45.24% lower than that in the control group （77.50%）（P<0.05）. The indwelling time of gastric tube in the observation group was 7.73 0.65 shorter than that in the control group 10.352.26（P<0.05）.The success rate of gastric tube extubation was not statistically significant（P>0.05）. The incidence of aspiration was 4.76% lower than that in the control group （P>0.05）. Conclusion Standard swallowing function assessment combined with volume-viscosity swallowing test can accurately formulate the diet plan of neurosurgical patients with dysphagia，reduce the indwelling time of gastric tube，reduce the incidence of aspiration and ensure the safety of eating.
【Key words】 Dysphagia； standardized swallowing assessment； Volume-viscosity swallowing test； Dietaryg guidance
