Abstract: Objective　To explore the application effect of multidisciplinary collaborative rehabilitation nursing mode in stroke patients with dysphagia. Methods　A prospective study was conducted. A total of 94 stroke patients with dysphagia admitted to Zhumadian Central Hospital from March 2019 to March 2022 were divided into a control group and an observation group by the random number table method, with 47 cases in each group. The control group had 24 males and 23 females who were (65.93±2.15) years old, and took routine nursing for 4 weeks. The observation group had 25 males and 22 females who were (65.89±2.13) years old, and took multidisciplinary collaborative rehabilitation nursing for 4 weeks. The swallowing function, psychological states, nutritional status, complications, and quality of life in the two groups were compared. t andχ² tests were applied. Results　The swallowing function of the observation group after nursing was better than that of the control group, with a statistical difference (Z=3.398, P=0.001). The scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) after nursing were (38.46±2.15) and (34.65±2.03) in the observation group, and were (49.87±2.19) and (40.83±2.06) in the control group, with statistical differences (t=25.488 and 14.649; both P<0.001). The levels of hemoglobin (Hb), albumin (ALB), and prealbumin (PA) after nursing were (120.76±12.94) g/L, (43.67±4.34) g/L, and (255.72±20.69) mg/L in the observation group, and were (106.49±11.63) g/L, (39.67±4.30) g/L, and (210.09±20.53) mg/L in the control group, with statistical differences (t=5.623, 4.489, and 10.733; all P<0.001). The incidence of complications in the observation group was lower than that in the control group [4.26% (2/47) vs. 17.02% (8/47)], with a statistically difference (χ²=4.029, P=0.045). The scores of energy, family activity, language, activity ability, emotion, personality, self-care ability, social role, thinking, upper limb function, vision, and work of Stroke-Specific Quality of Life Scale (SS-QOL) after nursing were (11.18±1.36), (9.96±1.35), (16.89±2.54), (22.37±2.61), (16.87±2.38), ( 9.94±1.12), (18.96±2.43), (16.89±2.28), (11.28±1.39), (15.57±2.19), (10.24±1.18), and (9.24±1.32) in the observation group, and were (8.94±1.34), (6.84±1.21), (13.59±2.51), (18.96±2.57), (13.38±2.34), (6.92±1.05), (14.48±2.40), (13.57±2.24), (8.94±1.37), (12.38±2.17), (7.78±1.16), and (6.98±1.30) in the control group, with statistical differences (t=8.043, 11.799, 6.336, 6.382, 7.169, 13.486, 8.993, 7.121, 8.220, 7.094, 10.192, and 8.363; all P<0.001). Conclusion　The multidisciplinary collaborative rehabilitation nursing mode for stroke patients with dysphagia can improve their swallowing function, adverse mood, nutritional status, and quality of life, and decrease the incidence of complications such as aspiration pneumonia.

Key words: Stroke, Dysphagia, Multidisciplinary collaborative rehabilitation nursing, Swallowing function, Psychological state, Nutritional status, Aspiration pneumonia

摘要： 目的　探讨多学科协作康复护理模式在脑卒中吞咽障碍患者中的应用效果。方法　采取前瞻性研究，将驻马店市中心医院2019年3月至2022年3月收治的脑卒中吞咽障碍患者94例按随机数字表法分为对照组和观察组，各47例。对照组男24例，女23例，年龄（65.93±2.15）岁，采取常规护理；观察组男25例，女22例，年龄（65.89±2.13）岁，实施多学科协作康复护理；两组均持续护理4周。比较两组吞咽功能、心理状态、营养状况、并发症和生活质量。采用t、χ²检验。结果　观察组护理后吞咽功能优于对照组，差异有统计学意义（Z=3.398，P=0.001）。观察组护理后焦虑自评量表（SAS）评分为（38.46±2.15）分、抑郁自评量表（SDS）为（34.65±2.03）分，均低于对照组［（49.87±2.19）分、（40.83±2.06）分］，差异有统计学意义（t=25.488、14.649，均P<0.001）。观察组护理后血红蛋白（Hb）、白蛋白（ALB）、前白蛋白（PA）水平分别为（120.76±12.94）g/L、（43.67±4.34）g/L、（255.72±20.69）mg/L，均高于对照组［（106.49±11.63）g/L、（39.67±4.30）g/L、（210.09±20.53）mg/L］，差异有统计学意义（t=5.623、4.489、10.733，均P<0.001）。观察组并发症发生率为4.26%（2/47），低于对照组的17.02%（8/47），差异有统计学意义（χ²=4.029，P=0.045）。观察组护理后脑卒中专用生活质量量表（SS-QOL）中精力、家庭活动、语言、活动能力、情绪、个性、自理能力、社会角色、思维、上肢功能、视力、工作评分分别为（11.18±1.36）分、（9.96±1.35）分、（16.89±2.54）分、（22.37±2.61）分、（16.87±2.38）分、（9.94±1.12）分、（18.96±2.43）分、（16.89±2.28）分、（11.28±1.39）分、（15.57±2.19）分、（10.24±1.18）分、（9.24±1.32）分，均高于对照组［（8.94±1.34）分、（6.84±1.21）分、（13.59±2.51）分、（18.96±2.57）分、（13.38±2.34）分、（6.92±1.05）分、（14.48±2.40）分、（13.57±2.24）分、（8.94±1.37）分、（12.38±2.17）分、（7.78±1.16）分、（6.98±1.30）分］，差异均有统计学意义（t=8.043、11.799、6.336、6.382、7.169、13.486、8.993、7.121、8.220、7.094、10.192、8.363，均P<0.001）。结论　脑卒中吞咽障碍患者实施多学科协作康复护理模式，可改善患者吞咽功能、不良情绪和营养状况，降低吸入性肺炎等并发症发生率，提升患者生活质量。

关键词: 脑卒中, 吞咽障碍, 多学科协作康复护理, 吞咽功能, 心理状态, 营养状况, 吸入性肺炎