| Objective:To explore the food rheology diet management scheme of patients with different levels of dysphagia,and to analyze the influence of food rheology diet management on the incidence of aspiration,nutritional status and quality of life of patients with dysphagia after stroke.Methods:The patients with stroke and dysphagia treated in a Grade 3A General Hospital from January to December 2019 were selected as the subjects.According to the order of hospitalization,the inpatients from January to June 2019 were set as the control group,and the patients from July to December 2019 were set as the observation group,120 patients in each group.The patients in the control group carried out routine nursing,including admission education,diet guidance,posture and activity,medication nursing,psychological nursing,nursing of enteral nutrition,language training,nursing of urinary catheter,etc.On the basis of nursing in the control group,the patients in the observation group added food rheology diet management in the aspect of diet guidance,that is,according to the classification of patients with dysphagia,the corresponding food rheology diet management was adopted,and individualized diet guidance and intervention were carried out for patients with different swallowing dysfunction.Three weeks after intervention,the incidence of aspiration,nutritional status[subjective overall nutritional status assessment scale(PG-SGA)score,triceps skin fold thickness(TSF),body mass index(BMI),quality of life changes(swallowing specific quality of life scale SWAL-QOL)were observed and compared between the two groups.Results:1.Incidence of aspiration.among 120 patients in the observation group,11 patients had aspiration by mistake,the incidence rate was 9.17%;among 120 patients in the control group,30 patients had aspiration by mistake,the incidence rate was 25%.the incidence of aspiration by mistake in the observation group was significantly lower than that in the control group(P<0.05).2.PG-SGA score.The scores of the control group were(4.97±1.42),(4.75±1.16),(4.15 ± 1.17)and(3.90 ± 0.65)on the day of admission and the first,second and third weeks,respectively.The scores of the observation group were(4.95 ± 1.45),(4.71±0.99),(4.09±1.27)and(3.29±0.97)on the day of admission and the first,second and third weeks,respectively.There was no significant difference in PG-SGA between the two groups on the day of admission(P>0.05).The results of repeated measurement analysis of variance showed that PG-SGA score had statistical significance in different time and time interaction between groups(P<0.05),but no statistical significance between groups(P>0.05).There was no significant difference between the two groups(P>0.05)on the day of admission and the first week,and there was significant difference between the two groups(P<0.05).Compared with the first week,the second week and the third week,the difference was statistically significant(P<0.05);compared with the observation group,the difference was statistically significant(P<0.05).3.TSF test score.The TSF of the control group was(12.73 ± 1.11)mm,(12.57±0.14)mm,(12.68±0.83)mm,(12.77±0.60)mm on the day of admission,and that of the observation group was(12.71±0.52)mm,(12.61±0.42)mm,(12.90±0.52)mm,(13.11 ±0.42)mm on the day of admission,and on the day of admission,respectively.There was no significant difference in TSF between the two groups on the day of admission(P>0.05).The results showed that the difference of TSF in different time and interaction between groups was statistically significant(P<0.05)and between groups was statistically significant(P<0.05).In the control group,the difference between the two groups was statistically significant(P<0.05)on the day of admission and the first week,but not statistically significant(P>0.05)compared with the second and third weeks;the difference between the first week and the second and third weeks was statistically significant(P<0.05);the difference between the second and the third weeks was not statistically significant.There was no significant difference between the two groups(P>0.05)on the day of admission and the first and second weeks,and there was significant difference between the two groups(P<0.05).The difference was statistically significant(P<0.05).4.BMI measurement score.The BMI of the control group was(21.13±0.51)kg/m2,(21.57±0.15)kg/m2,(22.08±0.80)kg/m2,(22.33±0.53)kg/m2 on the day of admission,and that of the observation group was(21.04±0.49)kg/m2,(21.61±0.43)kg/m2,(22.90 ± 0.51)kg/m2,and that of the observation group was(23.46±0.62)kg/m2 on the day of admission.There was no significant difference in BMI between the two groups on the day of admission(P>0.05).The results of repeated measurement analysis of variance showed that BMI had statistical significance(P<0.05)in different time and interaction between groups and time(P<0.05).The difference of BMI in the control group was statistically significant(P<0.05)compared with that in the first week,the second week and the third week(P<0.05).The difference of BMI in the observation group was statistically significant(P<0.05)compared with that in the first week,the second week and the third week(P<0.05).5.SWAL-QOL score.The scores of the control group were(112.07±11.42),(114.01±10.12),(119.60 ± 10.38),(123.92±11.55)on the day of admission and the first,second and third weeks,respectively.The scores of the observation group were(111.90 ± 10.45),(114.71±10.92),(124.49±11.27),(138.28±12.90)on the day of admission and the first,second and third weeks,respectively.There was no significant difference between the two groups on the day of admission(P>0.05).After repeated measurement analysis of variance,the results showed that the SWAL-QOL score reflecting the quality of life had statistical significance(P<0.05)in different time and interaction between groups and time,and also had statistical significance(P<0.05)between groups.The difference between the two groups was statistically significant(P<0.05).The difference between the two groups was statistically significant(P<0.05).Conclusion1.Using the principle of food rheology,the management of food rheology by changing food traits,types,diet speed,one mouthful,food calories and so on can reduce the incidence of aspiration,promote the smooth progress of eating,improve the safety of swallowing,and reduce the occurrence of complications,which is worthy of clinical application.2.Food rheology diet management according to the grade of swallowing function of patients can increase the thickness of brachial triceps skin fold,body mass index and reduce the subjective overall nutritional status score of patients with malnutrition,which is an important means to improve the malnutrition status of patients with dysphagia after stroke.3.Food rheology diet management based on swallowing function grading can improve the SWAL-QOL score of patients and improve the quality of life of patients with dysphagia after stroke. |
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