Study On The Effect Of Early Recognition And Intensive Swallowing Training Programs In Patients With Acquired Swallowing Disorders After The Posterior Fossa Tumor Surgery

[Objective]This study focused on the rehabilitation nursing of patients with acquired swallowing disorders after the posterior fossa tumor surgery,and explored feasible,scientific and effective early recognition and swallowing training programs.It aimed to improve the detection rate of acquired swallowing disorders and swallowing function,reduce the incidence of cough during screening and the percentage of indwelling nasal feeding tube,shorten the indwelling time of nasal feeding tube,and relieve anxiety.It was to provide theoretical reference and data support for the rapid recovery of patients with acquired swallowing disorders.[Methods]This study was divided into two parts.Part Ⅰ:130 patients with posterior fossa tumors were randomly divided into the control group(n=65)and the intervention group(n=65).The control group was treated with conventional methods(Water Swallow Test),and the intervention group was treated with an early recognition program.The detection rate of acquired swallowing disorders and the incidence of cough during screening were compared between the two groups.Part Ⅱ:60 patients with acquired swallowing disorders after posterior fossa tumor surgery were randomly divided into the control group(n=30)and the intervention group(n=30).The control group received routine nursing(feeding guidance,health education to prevent aspiration,etc.),while the intervention group received intensive swallowing training on the basis of routine nursing.The scores of Standardized Swallowing Assessment Scale,the indwelling time of nasal feeding tube,the percentage of indwelling nasal feeding tube at discharge,and the scores of Hamilton Anxiety Scale were compared between the two groups.[Results]The results of part Ⅰ:14 patients(21.54%)in the control group were detected with acquired swallowing disorders,while 25 patients(38.46%)in the intervention group were detected.The difference between the two groups was statistically significant(χ~2=4.43,P=0.04).71person-time(15.60%)in the control group had cough during the screening,and 49 person-time(10.77%)in the intervention group had cough.The difference between the two groups was statistically significant(χ~2=4.65,P=0.03).The results of part Ⅱ:the scores of Standardized Swallowing Assessment Scale in the control group and intervention group were 28.68±4.26 and 26.41±3.90 respectively.There were significant differences in scores of Standardized Swallowing Assessment Scale(t=2.06,P=0.04).The indwelling time of nasal feeding tube in the control group and intervention group were 8.07±2.14 days and 6.81±1.67 days respectively,with statistically significant differences(t=-2.42,P=0.02).The percentage of indwelling nasal feeding tube at discharge in the control group was higher than that in the intervention group(39.29%VS 18.52%),without significant differences(χ~2=2.87,P=0.09).The scores of Hamilton Anxiety Scale in the control group and intervention group were 18.36±6.06 and 15.33±4.91 respectively,with statistically significant differences(t=2.03,P=0.04).[Conclusions]Compared with conventional methods,the early recognition program had certain advantages in improving the detection rate of acquired swallowing disorders and reducing the incidence of cough during the screening process.In addition,intensive swallowing training programs could improve swallowing function,reduce the percentage of indwelling nasal feeding tube,shorten the indwelling time of nasal feeding tube,and relieve anxiety.