中风吞咽困难的康复护理课件.ppt

1、As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.As the only big agricultural village in Tianding Township,some achievements have been made through the beneficia

2、l exploration of villagers autonomy in family planning for more than a year.吞咽障碍是老年脑中风患者常见的并发症 由于患者在脑中风早期存在不同程度的吞咽障碍，进食困难，若得不到及时有效的康复护理。患者可因吞咽障碍易出现误吸，发生吸入性肺炎，严重者可因窒息而危及生命。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of

3、villagers autonomy in family planning for more than a year.因此，在脑中风早期有计划地根据病情对意识清楚的吞咽障碍患者进行康复护理，使患者及时得到足够的营养补充，增强机体抵抗力，对疾病的康复有着重要的意义。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning f

4、or more than a year.吞咽功能训练 发音训练 由于吞咽障碍时咽喉反射是不随意的，而体内器官很难接近，从发音和语言器官考虑皆和咽下有关，可用言语进行康复训练。如属患者张口发“a”音，并向两侧运动发“yi”音，然后再发“wu”音。也可嘱患者缩唇然后发“f”音，像吹蜡烛、吹哨动作。发音训练一般在晨间护理后及午睡起床后进行，每次每音发3次，连续510次。通过张闭口动作促进口唇肌肉运动。As the only big agricultural village in Tianding Township,some achievements have been made through th

5、e beneficial exploration of villagers autonomy in family planning for more than a year.舌部运动 嘱患者开口，将舌头向前伸出，然后作左右运动摆向口角，再用舌尖舔下唇后转舔上唇，按压硬腭部，每隔5min作一次以上运动，每天3次，分别于早、中、下午进行。若患者不能自动进行舌运动时，护士可用压舌板或匙在舌部按摩或嘱患者将舌伸出时用纱布轻轻把持舌进行上下左右运动。As the only big agricultural village in Tianding Township,some achievements ha

6、ve been made through the beneficial exploration of villagers autonomy in family planning for more than a year.脸、下颌及喉部运动 嘱患者作微笑或皱眉，张口后闭上，然后鼓腮，使双颊部充满气体后轻轻吐气，如此反复进行，每天3次。也可帮助患者洗净手后作吮手指动作以收缩颊部、口轮匝肌肉运动。通过主动或被动地活动患者下颌，嘱患者作咀嚼动作，每天反复练习3次。喉部吞咽训练时，护士可将拇指和食指轻置于患者喉部适当位置，嘱患者反复作吞咽动作练习。As the only big agricultural

7、 village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.进食训练 进食时患者的正确体位 食物形态 用量及综合训练As the only big agricultural village in Tianding Township,some achievements have been made through the beneficia

8、l exploration of villagers autonomy in family planning for more than a year.目的是促进摄取足够营养，使患者具备足够的体力，逐步恢复自行进食能力。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.进食

9、时的最佳体位 进食前应嘱患者放松精神，保持轻松、愉快情绪1530min，然后让患者坐直(坐不稳时可使用靠背架)或头稍前倾45?左右，这样使在进食时食物由健侧咽部进入食道或可将头部轻转向瘫痪侧90?，使健侧咽部扩大便于食物进入。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year

10、.食物选择 根据老年人饮食特点及吞咽障碍的程度，选择易被患者接受的食物，尤其要注意南方人喜稻米，北方人爱面食的饮食习惯，再由营养食堂配以鲜牛奶、蔬菜汁和果汁等。将食物做成冻状或糊状以便进食。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.进食的协助 当患者开始进食时，护士

11、可协助患者将食物放在口腔健侧，一般食团摄入每次以1汤匙大小为宜，放入食团后可将匙背轻压舌部一下，以刺激患者吞咽。每次进入小食团后，嘱患者反复吞咽数次，以使食物全部通过咽部，每咽下一口应清理口腔一次。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.在协助患者进食过程中，可适

12、当给患者喝一口白开水，一般不用吸管，以免液体误入气管。为防止吞咽时食物误吸入气管，在进食时先嘱患者吸足气，吞咽前及吞咽时憋住气，这样可使声带闭合封闭喉部后再吞咽，吞咽后咳嗽一下，将肺中气体排出，以喷出残留在咽喉部的食物残渣。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.

13、对因真性球麻痹而致口腔或咽部运动障碍，不能维持由口摄入足够饮水量与热量的患者，可用鼻饲的方法进行鼻饲，待进行吞咽功能训练有效后再行经口饮食训练 As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.心理护理 做好心理护理是训练成功的基础和保证。老年脑中风吞咽障碍患者由于还同时存

14、在不同程度的肢体瘫痪或失语、语言不清等，表达力差，加上年老体弱、唾液分泌减少、牙齿脱落等原因不能进食而易出现烦躁、易怒和情绪抑郁，有的甚至拒食。而吞咽障碍的康复又不是一朝一夕能够实现的。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.因此，我们在进行吞咽障碍功能训练和进食

15、训练时，努力为患者创造一个清洁、安静、舒适的环境，同时还针对老年人的性格特点、文化程度和社会阅历等有的放矢地进行心理疏导。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.讨 论 早期进行吞咽功能训练可防止咽下肌群发生废用性萎缩，加强舌和咀嚼肌的按摩和运动，提高吞咽反射的灵活性。使患者进食时吞咽功能密切配合，从而避免发生误吸，防止肺部并发症发生。可避免患者出现脱水或营养不良，提高患者生活质量，使疾病早日康复。As the only big agricultural village in Tianding Township,some achievements have been made through the beneficial exploration of villagers autonomy in family planning for more than a year.