护理研究
目的 探讨行动研究法的倾向、强化及促成因素(PRECEDE)护理模式在冠心病患者中的应用效果。方法 选取2022年3月—2023年3月新乡市中心医院心内科收治的120例冠心病患者为研究对象,根据其住院ID号,以1:1比例分为对照组与观察组各60例,前者实施PRECEDE护理模式,后者实施基于行动研究法的PRECEDE护理模式,对比两组心功能指标干预前后检测情况、遵医行为及疾病相关知识掌握情况。结果 干预后3个月,观察组左室射血分数(LVEF)高于对照组及干预前,左心室收缩末期容积指数(LVESVⅠ)及左心室舒张末期容积指数(LVEDVⅠ)低于对照组及干预前(P<0.05)。观察组遵医行为比例和相关知识总掌握率均高于对照组(P<0.05)。结论 冠心病患者实施基于行动研究法的PRECEDE护理模式,不仅有助于改善其心功能指标,还能改善其遵医行为,提高其疾病知识掌握率。
护理研究
目的 探讨远程药学管理模式联合延续护理在2型糖尿病(T2DM)合并冠状动脉病变患者居家用药中的应用效果。方法 选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表(SF-36)]及心血管事件发生情况。结果 研究组用药、饮食、运动依从性均高于常规组(P<0.05)。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组(P<0.05)。相较于干预前,两组患者在干预后的活力(VT)、精神健康(MH)、情感职能(RE)、躯体疼痛(BP)、生理功能(PF)、社会功能(SF)、生理职能(RP)、总体健康(GH)分值均升高,且研究组高于常规组(P<0.05)。研究组与常规组患者心血管不良事件发生率分别为2例(2.00%)、15例(15.09%),研究组高于常规组(χ2=10.865,P<0.05)。结论 远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。
Objective To explore the application effect of remote pharmacy management mode combined with continuous nursing in the home medication of type 2 diabetes mellitus(T2DM)patients with coronary artery disease.Methods A total of 200 patients with T2DM complicated with coronary artery diseases who were diagnosed and treated in the Third Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2023 were selected as the study subjects.They were divided into a conventional group of 100 patients and a study group of 100 patients based on different intervention methods.The patients in the conventional group received routine care both in and out of the hospital,while the study group received remote pharmaceutical management mode combined with continuous care on the basis of the conventional group.Patient medication compliance,dietary compliance,exercise compliance,self-management ability,quality of life[36 item concise health scale(SF-36)] and incidence of adverse cardiovascular events were assessed.Results The compliance of medication,diet and exercise in the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the self-management function,sense of responsibility,self-concept and health knowledge scores of both groups of patients were significantly increased after intervention,and the scores of the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the Vitality(VT),Mental Health(MH),Emotional Function(RE),Physical Pain(BP),Physiological Function(PF),Social Function(SF),Physiological Function(RP)and Overall Health(GH)scores of both groups of patients were significantly increased after intervention,and the scores of the study group was significantly higher than those of the conventional group(P<0.05).The incidence of cardiovascular adverse events in the study group and the conventional group were 2 cases(2.00%)and 15 cases(15.09%),respectively,with the study group significantly higher than the conventional group(χ2=10.865,P<0.05).Conclusions The combination of remote pharmaceutical management mode and continuous care can significantly improve the medication management compliance of T2DM patients with coronary artery disease,improve their self-management ability,improve the quality of their life and reduce the incidence of adverse cardiovascular events.
中西医结合/中医研究
目的 探索以解语丹联合靳三针为基础的不同治疗方案对卒中后失语症(PSA)的治疗效果。方法 收集广州市第一人民医院神经内科、中医科PSA患者120例,随机分为解语丹组、靳三针组、联合组和对照组,每组各30例。试验组除给予常规卒中治疗外,分别给予解语丹、靳三针及解语丹联合靳三针治疗,对照组仅给予常规卒中治疗,治疗周期共12周。分别利用西方失语成套测验(WAB)、汉语失语检查量表(ABC)、副反应量表(TESS)于试验前、试验2周及12周时对患者进行评估,并进行药物安全性评价,观察解语丹联合靳三针治疗卒中后失语症的临床治疗效果。结果 经2周治疗后,试验组各组WAB中的失语指数(AQ)、操作指数(PQ)、大脑皮质指数(CQ)评分分别为68.14±7.23;67.26±7.23;69.73±6.97、15.47±3.91;15.92±6.35;18.06±7.83、66.84±7.85;65.78±6.75;70.35±6.73,均较治疗前及对照组有明显改善,比较差异有统计学意义(P<0.05);试验组各组比较,联合组各项评分优于解语丹组和靳三针组,比较差异有统计学意义(P<0.05);治疗12周后,试验组WAB的AQ、PQ、CQ评分分别为91.87±7.81;85.75±6.87;94.58±7.83、31.57±7.38;25.67±6.28;35.72±8.31、89.74±6.98;84.16±6.79;93.56±7.88,与治疗2周后比较,差异有统计学意义(P<0.05)。言语功能各亚项评分显示,联合组在口语表达、听理解、复述、命名等方面优于其他各组,两两比较差异有统计学(P<0.05)。试验各组在2周及12周时,TESS评分比较差异无统计学意义(P<0.05)。统计分析表明,解语丹联合靳三针治疗卒中后失语症,2周后起效12周后效果更为明显。结论 解语丹联合靳三针早期治疗PSA患者能有效提升认知功能,改善患者的言语功能,提高患者的人际交往和生活自理能力,且具有较好的安全性,无严重不良反应,可为临床治疗PSA提供一种新的方法。
Objective To compare the therapeutic effects of different treatment plans based on Jieyu Dan combined with Jin's Three Needle on aphasia patients after stroke.Methods A total of 120 patients with aphasia after stroke in the neurology and traditional Chinese medicine departments of Guangzhou First People's Hospital were collected and randomly divided into Jieyu Dan group,Jin's Three Needle group,combined group and control group,with 30 cases in each group.The treatment groups were treated with Jieyu Dan,Jin's Three Needle and Jieyu Dan combined with Jin's Three Needle respectively,in addition to conventional stroke treatment.The control group was only treated with conventional stroke treatment,with a total treatment period of 12 weeks.The Western Aphasia Battery(WAB),Aphasia Battery of Chinese(ABC)and Treatment Emergent Symptom Scale(TESS)were used to evaluate patients before,at 2 weeks and 12 weeks of the trial,and drug safety was evaluated to observe the clinical therapeutic effect of Jieyu Dan combined with Jin's Three Needle in treating post stroke aphasia.Results After 2 weeks of treatment,the aphasia quotient(AQ),performance quotient(PQ),cortical quotient(CQ)scores of WAB in each group of the experimental group were 68.14±7.23,67.26±7.23,69.73±6.97;15.47±3.91,15.92±6.35,18.06±7.83;66.84±7.85,65.78±6.75,70.35±6.73,respectively,and all significantly improved compared to before treatment and the control group,with significant differences(P<0.05).Compared with the experimental group,the combined group had better scores than the Jieyu Dan group and Jin's Three Needle group,with a statistically significant difference(P<0.05).After 12 weeks of treatment,the AQ,PQ,and CQ scores of the experimental group's WAB were 91.87±7.81,85.75±6.87,94.58±7.83;31.57±7.38,25.67±6.28,35.72±8.31;89.74±6.98,84.16±6.79,93.56±7.88,respectively.Compared with 2 weeks of treatment,the difference was statistically significant(P<0.05).The scores of each sub item of speech function showed that the combined group was significantly better than the other groups in terms of oral expression,listening comprehension,retelling,naming,etc.,with statistical significance(P<0.05).At 2 and 12 weeks,there were no significant statistical differences in TESS scores among the experimental groups(P<0.05).Statistical analysis showed that the combination of Jieyu Dan and Jin's Three Needle in the treatment of post-stroke aphasia had a more significant effect after 2 weeks and 12 weeks.Conclusions The combination of Jieyu Dan and Jin's Three Needle can effectively improve cognitive function and enhance patients' self-care ability in the early treatment of aphasia after stroke.The clinical efficacy is significant and has good safety,making it an effective treatment plan for aphasia after stroke.
论著
目的 观察环泊酚在老年患者无痛胃肠镜检查中的麻醉效果和不良反应。方法 选择80例65岁以上行无痛胃肠镜检查的老年患者,将患者随机分为环泊酚组(C组)40例和丙泊酚组(P组)40例。每例患者均静脉注射舒芬太尼0.08 μg/kg,30 s后C组给予环泊酚0.3 mg/kg、P组给予丙泊酚1.5 mg/kg。记录2组患者麻醉前(T0)、睫毛反射消失时(T1)、置入胃镜后即刻(T2)和操作结束时(T3)的心率(HR)和平均动脉压(MAP);记录2组患者检查操作时间、清醒时间、追加药物次数及静脉注射痛、呼吸抑制、呛咳、体动等不良反应发生情况。结果 2组患者行胃肠镜检查操作时间、麻醉清醒时间和追加药物次数比较差异无统计学意义(P>0.05)。与T0时间点(102.6±14.1 mmHg)比较,P组患者的MAP在T1(86.0±12.5 mmHg)、T2(86.1±13.2 mmHg)、T3(92.8±12.6 mmHg)时间点明显下降,差异有统计学意义(P<0.05);与C组T1(95.9±10.8 mmHg)、T2(96.3±9.6 mmHg)时间点比较,P组的MAP在T1(86.0±12.5 mmHg)、T2(86.1±13.2 mmHg)时均明显降低(P<0.05)。C组患者静脉注射痛、呼吸抑制的发生率明显低于P组(P<0.05);2组体动和呛咳的发生率比较差异无统计学意义(P>0.05)。结论 环泊酚0.3 mg/kg在老年患者胃肠镜检查中能提供和丙泊酚1.5 mg/kg相似的麻醉效果,环泊酚组的老年患者发生注射痛、血压下降、呼吸抑制的比例更低。
Objective To observe the effect of ciprofol and propofol in painless gastroenteroscopy in elderly patients.Methods A total of 80 elderly patients aged 65 or above who underwent painless gastroenteroscopy were randomly divided into a group of 40 patients receiving ciprofol(Group C)and a group of 40 patients receiving propofol(Group P).All patients were given sufentanil 0.08 μg/kg,and group C was given ciprofol 0.3 mg/kg,group P was given propofol 1.5 mg/kg after 30 seconds.The heart rate(HR)and mean arterial pressure(MAP)of two groups of patients before anesthesia(T0),at the disappearance of eyelash reflex(T1),after gastroscopy insertion(T2),and at the end of the procedure(T3)were recorded.The operating time,anesthesia awakening time,number of additional medications and the adverse reactions such as injection pain,respiratory depression,cough,body movements were also recorded.Results There were no significant differences(P>0.05)in the gastroenteroscopy operating time,recovery time and number of additional medications between the two groups.Compared with T0 time point(102.6±14.1 mmHg),the MAP of group P patients significantly decreased at T1(86.0±12.5 mmHg),T2(86.1±13.2 mmHg)and T3(92.8±12.6 mmHg)time points(P<0.05).Compared with Group C at T1(95.9±10.8 mmHg),T2(96.3±9.6 mmHg)time points,the MAP of Group P decreased significantly at T1(86.0±12.5 mmHg)and T2(86.1±13.2 mmHg)time points(P<0.05).The incidences of injection pain and respiratory depression in group C were significantly lower than those in group P(P<0.05).There was no statistically significant difference in the incidences of body movements and cough between the two groups(P>0.05).Conclusions Ciprofol 0.3 mg/kg combined with sufentanil can provide anesthesia effect similar to that of propofol 1.5 mg/kg combined with sufentanil in gastroenteroscopy of elderly patients.The proportions of injection pain,blood pressure decreasing and respiratory depression in elderly patients in the ciprofol group were lower.
论著
目的 探讨重复经颅磁刺激应用于帕金森病失眠患者中的效果及对睡眠质量的影响。方法 选取2021年1月—2022年3月南阳南石医院神经内科收治的帕金森病失眠患者100例,按照随机数字表法均分为参照组(n=50)和研究组(n=50),参照组采用常规西药治疗,研究组在参照组基础上采用重复经颅磁刺激治疗,对比两组治疗效果、神经递质指标水平、帕金森症状表现及睡眠质量评分的差异。结果 研究组治疗总有效率98.00%(49/50)高于参照组82.00%(41/50),对比差异有统计学意义(P<0.05)。治疗后,研究组神经递质多巴胺及5-羟色胺水平分别为(6.84±0.62)、(22.75±0.59),均高于参照组,对比差异均有统计学意义(P<0.05)。治疗后,研究组帕金森病症状表现及睡眠质量总评分均低于参照组,对比差异均有统计学意义(P<0.05)。结论 重复经颅磁刺激应用到帕金森病失眠患者的治疗中,能提升疗效,明显改善患者睡眠质量和帕金森病症状。
Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on Parkinson's insomnia and its influence on sleep quality.Methods A total of 100 Parkinson's patients with insomnia admitted to the Department of Neurology,Nanyang Nanshi Hospital from January 2021 to March 2022 were selected and divided into the reference group(n=50)and the study group(n=50)according to random number table method.The reference group was treated with conventional western medicine,and the study group was treated with rTMS on the basis of the reference group.The levels of neurotransmitters,symptoms of Parkinson's disease and sleep quality were compared.Results The effective rate of the study group was 98.00%(49/50),which was higher than 82.00%(41/50)of the reference group,with statistical significance(P<0.05).After treatment,the levels of dopamine and 5-hydroxytryptamine in the study group,(6.84±0.62)and(22.75±0.59),were higher than those in the reference group,and the comparison was statistically significant(P<0.05).After treatment,the total score of Parkinson's symptom and sleep quality in the study group were lower than those in the reference group,with statistical significance(P<0.05).Conclusions The application of rTMS in the treatment of Parkinson's patients with insomnia can improve the curative effect,significantly improve the sleep quality and symptoms of Parkinson's disease,and is worthy of further application and promotion.
论著
目的 检验婴儿孤独症观察量表中文版(AOSI)临床应用的灵敏度与特异度,评价其临床应用效果。方法 随机抽取1岁时曾在清远市妇幼保健院行AOSI评估,于2~3岁时诊断为孤独症谱系障碍(ASD)的48例患儿为ASD组,诊断为正常发展的46例幼儿作为对照组。比较两组患儿的18个条目得分和总分,采用受试者操作特征(ROC)曲线计算AOSI的特异度、灵敏度、阳性预测值与阴性预测值,并判断AOSI的最佳诊断(阳性)分界值;分析AOSI评估结果与《精神障碍诊断与统计手册(第5版)》(DSM-5)中ASD诊断标准的一致性。结果 两组研究对象性别、年龄比较差异无统计学意义(P>0.05)。ASD组各条目得分和总分均高于对照组,且差异具有统计学意义(P<0.01)。AOSI的曲线下面积(AUC)为1.00(P<0.01),95%置信区间为(1.00,1.00)。不同阳性分界线的灵敏度、特异度、阳性预测值、阴性预测值及一致性相比较,当约登指数等于1.00时AOSI的最佳诊断(阳性截断值)界线为9分时,其上述值均为1.00。AOSI评估结果与DSM-5中ASD的诊断标准完全相一致(Kappa=1,P<0.01)。结论 AOSI应用于评估1岁的婴儿,当取9分为诊断界值时,具有高度的灵敏度与特异度,能较好地预测该婴儿在2~3岁时是否患ASD;AOSI是婴儿期ASD筛查的重要工具,其评估结果可作为ASD高危儿早期干预的证据和ASD的辅助诊断工具,适合于临床推广应用。
Objective To test the sensitivity and specificity of the Chinese version of the Autism Observation Scale for Infants(AOSI)in clinical application and evaluate its clinical application effect.Methods Forty-eight children with autism spectrum disorder(ASD)diagnosed at the age of 2 to 3 years who had undergone AOSI evaluation in Qingyuan Maternal and Child Health Hospital at the age of 1 year(2021)were randomly selected as the ASD group,and 46 children with normal development were randomly selected as the control group.The scores of 18 items and total scores of the two groups of subjects were compared.The specificity,sensitivity,positive predictive value and negative predictive value of AOSI were calculated using the receiver operating characteristic curve(ROC),and the best diagnostic(positive)cut-off value of AOSI was confirmed.The consistency of AOSI evaluation results with the ASD diagnostic criteria in DSM-5 were compared.Results There was no statistically significant difference in genders or age between two groups(P>0.05).The scores of each item and total scores in the ASD group were significantly higher than those in the control group,and the difference was statistically significant(P<0.01).The area under the curve of AOSI(AUC=1.00,P<0.01)had a 95% confidence interval of(1.00,1.00).Comparing the sensitivity,specificity,positive predictive value,negative predictive value and consistency of different positive boundary points,when the Youden index was equal to 1.00,the optimal diagnostic(positive cut-off value)boundary for AOSI was 9 points,and all of the above values were 1.00. The AOSI evaluation results were completely consistent with the diagnostic criteria for ASD in DSM-5(Kappa=1,P<0.01).Conclusions AOSI has high sensitivity and specificity when it is used to evaluate the 1-year-old infant.When “9 points” is taken as the diagnostic threshold,it can better predict whether the infant has ASD at the age of 2~3 years.AOSI is an important tool for screening ASD in infancy.Its evaluation results can be used as evidence for early intervention of high-risk infants with ASD and as a assisting tool to diagnosis ASD,which is suitable for clinical application.
综述
脑卒中是临床常见的急性脑血管疾病,常有偏瘫、肩手综合征、下肢深静脉血栓等后遗症,严重影响患者的生活质量。温针疗法是中医传统的特色疗法,近年来,应用以温针为主的相关疗法治疗脑卒中后遗症的报道越来越多,在临床上得到广泛应用。本文归纳分析了近10年来温针疗法治疗脑卒中后肩手综合征、偏瘫、下肢深静脉血栓三大主要疾病的案例及研究,以期为相关研究与应用提供参考。
Stroke is a common acute cerebrovascular disease in clinical practice,which frequently leaves sequelae like hemiplegia,shoulder-hand syndrome and deep vein thrombosis of the lower extremities,and vastly reduces the quality of life of patients.Warm needling is a characteristic therapy of traditional Chinese medicine.In recent years,there have been more and more reports of warm needling-based related therapies for the treatment of stroke sequelae,and it has been widely used in clinical practice.This article summarizes and analyzes the cases and studies of warm needing therapy in the treatment of shoulder-hand syndrome,hemiplegia and deep vein thrombosis of the lower extremities after stroke in the past 10 years,so as to provide reference for related research and application.
专家述评
血友病是一种由于X染色体上凝血因子基因突变所致的遗传性出血性疾病,目前主要的治疗方法是凝血因子替代疗法。但长期频繁的注射用药往往导致患者依从性差,容易产生抑制性抗体,从而影响治疗效果。虽然现在延长半衰期的新型凝血因子药物、人源化双特异性抗体以及抗组织因子途径抑制剂单克隆抗体等用于疾病治疗,在给药方式和作用持续时间上已有很大进步,但它们仍无法治愈血友病。因此,以疾病根治为重要目标的基因治疗被设计出来,近年来受到了广泛的关注。该文介绍了血友病基因治疗的原理、基因治疗载体的选择、基因治疗预处理方案,总结了现阶段基因治疗临床应用的安全性和有效性;最后讨论基因治疗目前存在的问题以及未来发展方向。
Hemophilia is a genetic bleeding disorder resulting from mutations in coagulation factor genes on the X chromosome.The mainstay of current treatment is coagulation factor replacement therapy.However,frequent and long-term injections often lead to poor patient compliance,easy inhibitor development,and compromised therapeutic efficacy.Despite advancements in delivery methods and prolonged action of novel agents such as extended half-life coagulation factor concentrates,humanized bispecific antibodies,and anti-tissue factor pathway inhibitor monoclonal antibodies,these approaches still fall short of curing hemophilia.Consequently,gene therapy,aiming for disease eradication,has garnered significant attention in recent years.This review delves into the principles of gene therapy,the selection of gene therapy vectors,and gene therapy preconditioning regimens.It summarizes the safety and efficacy of gene therapy in current clinical applications and discusses challenges and future directions in this field.
医学教育
目的 了解深圳市助产士培训的现况,为今后进一步加强助产士培训工作提供参考依据。方法 利用方便整群抽样法选取2022年在深圳市助产医疗机构工作的助产士,通过问卷调查及数据分析,了解他们在2009—2020年间参加助产士培训的情况以及对临床实操技能掌握的自评现况。结果 本研究共调查481名助产士,大部分来自三级医院,平均拥有9(5,15)年的助产工作经验,根据其工作年限和经验分别参加初级、中级和(或)高级培训,以参加一次初级或中级培训居多。助产士未参加培训的主要原因为医院人员不足和新入职。临床实操技能掌握自评现况分析显示,助产士初、中级母儿急救实操技能亟待加强,中级培训的助产士带教能力需提升。不同职称助产士的实操技能自评分数比较差异有统计学意义(Z=9.23,P=0.026)。结论 深圳市助产士对于初级培训和中级培训的参与度较高,但对部分临床实操技能的掌握仍存在不足,有必要进一步强化助产士临床实操技能培养,以全面满足孕产妇的健康需求。
Objective To understand the current state of midwifery training in Shenzhen,providing insights for the enhancement of future midwifery training programs.Methods Using a convenience cluster sampling method,midwives working in obstetric medical institutions in Shenzhen in 2022 were selected.Through questionnaire surveys and data analysis,the participation in midwifery training from 2009 to 2020 was examined along with their self-assessment of mastery over clinical practical skills.Results A total of 481 midwives,mostly from tertiary hospitals,with an average of 9(5,15)years of midwifery experience,were surveyed in this study and participated in primary,intermediate and/or advanced training according to their years of experience and years of work,with the majority participating in primary or intermediate training once.The main reasons for midwives not attending training were insufficient hospital staff and new recruits.The analysis of the self-assessment of the mastery of clinical practical skills showed that the practical skills of midwives in maternal and pediatric emergencies at the primary and intermediate levels needed to be strengthened,and the teaching ability of midwives with intermediate training needed to be improved.There was a difference in the self-rating of practical skills among midwives of different titles(Z=9.23,P=0.026).Conclusions Though participation in primary and intermediate midwifery training in Shenzhen City is high,there remains a deficiency in mastering specific clinical practical skills.This research suggests that there’s a pressing need to further enhance the practical clinical skill training for midwives to comprehensively meet the health needs of pregnant and postnatal women.
论著
目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组(P<0.05)。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组(P<0.05)。干预后两组生活质量综合评定量表评分升高,观察组高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。
Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders.Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases.Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training.The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications.Results The observation group was generally more effective than the control group(P<0.05).After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group(P<0.05).After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group(P<0.05).The complication rate was lower in the observation group(P<0.05).Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes.