基于早期预警评分(EWS)的卒中患者吞咽功能动态评估与分级护理在降低误吸中的应用

Application of Dynamic Assessment and Graded Nursing of Swallowing Function in Stroke Patients Based on Early Warning Scoring (EWS) for Reducing Aspiration

摘要: 目的：探讨基于早期预警评分(EWS)的吞咽功能动态评估与分级护理在急性卒中患者中降低误吸、预防吸入性肺炎的应用效果。方法：选取2023年1月~2025年6月我院神经外科卒中伴吞咽障碍患者120例，随机分为观察组和对照组各60例。对照组采用常规吞咽评估与护理；观察组以EWS进行危险分层，联合洼田饮水试验、标准吞咽功能评价量表(SSA)动态评估，并实施分级护理。比较两组误吸发生率、吸入性肺炎发生率、吞咽功能及护理满意度。结果：观察组误吸发生率3.33%、吸入性肺炎发生率5.00%，均低于对照组13.33%、18.33% (P < 0.05)；干预后观察组吞咽功能分级优于对照组(P < 0.05)；观察组护理满意度96.67%，高于对照组85.00% (P < 0.05)。结论：基于EWS的动态评估与分级护理可有效降低卒中患者误吸及吸入性肺炎风险，改善吞咽功能，提高护理质量与安全性，值得临床推广。

Abstract: Objective: To investigate the effect of dynamic assessment of swallowing function and graded nursing based on Early Warning Score (EWS) in reducing aspiration and preventing aspiration pneumonia in stroke patients. Methods: A total of 120 Neurosurgical stroke patients with dysphagia admitted to our hospital from January 2023 to June 2025 were randomly divided into observation group and control group, with 60 cases in each group. The control group received routine swallowing assessment and nursing, while the observation group received dynamic assessment combined with Water Swallow Test and Standard Swallowing Assessment (SSA) based on EWS risk stratification and corresponding graded nursing. The incidence of aspiration, aspiration pneumonia, swallowing function and nursing satisfaction were compared. Results: The incidence of aspiration (3.33%) and aspiration pneumonia (5.00%) in the observation group were significantly lower than those in the control group (13.33% and 18.33%, P < 0.05). The swallowing function grade and nursing satisfaction (96.67%) in the observation group were significantly better than those in the control group (85.00%, P < 0.05). Conclusion: EWS-based dynamic assessment and graded nursing can effectively reduce the risk of aspiration and aspiration pneumonia, improve swallowing function and nursing safety in stroke patients, which is worthy of clinical application.