多学科团队管理对脑损伤吞咽障碍患者吞咽功能的影响

目的:探讨多学科团队管理对脑损伤吞咽障碍患者吞咽功能的疗效影响。方法:入选脑损伤后吞咽障碍患者60例,随机分为对照组和观察组各30例,其中对照组采用常规综合吞咽障碍康复方案,观察组在常规方案的基础上采用多学科吞咽团队管理方案。使用洼田饮水试验、视频透视吞咽功能检查(Video Fluoroscopic Swallowing Study,VFSS)比较2组患者吞咽功能改善程度,使用体重指数(Body Mass Index,BMI)18.5、吸入性肺炎发生率比较2组并发症发生情况。结果:干预4周后,2组洼田饮水试验结果分级显示吞咽功能均较组内治疗前明显改善(P0.01),且观察组吞咽功能明显优于对照组(P0.01)。观察组吞咽功能障碍恢复总有效率明显高于对照组(P0.05)。2组VFSS评分均较治疗前明显提高(P0.01),观察组更高于对照组(P0.01)。观察组拔管率明显高于对照组(P0.05);观察组营养不良及吸入性肺炎发生率均明显低于对照组(P0.05)。结论:多学科吞咽团队管理下进行的康复干预方案可有效改善脑损伤吞咽障碍患者的吞咽功能及脑损伤后吞咽障碍患者营养不良,降低吸入性肺炎的发生率。

Effect of multidisciplinary swallowing team approach on cerebral injury patients with dysphagia

Objective: To explore the effect of the multidisciplinary swallowing team approach on cerebral injury patients with dysphagia. Methods: Sixty cerebral injury patients with dysphagia were randomly divided into control group and study group. The control group received the conventionally comprehensive rehabilitation intervention scheme. The study group received the multidisciplinary swallowing team approach including nutritionist, radiologist and the standard ingestion exercise scheme on the basis of the conventional rehabilitation scheme. The swallowing function was evaluated respectively by Video Fluoroscopic Swallowing Study (VFSS) and the incidence of malnutrition and aspiration pneumonia was also compared between the two groups. Results: The swallowing function of patients in the two groups was improved significantly (P<0.05), but that in the study group was improved greater than that in the control group (P<0.05). The incidence of malnutrition and aspiration pneumonia in the study group was significantly lower than that in the control group (P<0.05). Conclusion: The multidisciplinary swallowing team approach can accelerate the recovery of swallowing function as compared with ordinary rehabilitation scheme for inpatients with dysphagia and reduce the incidence of malnutrition and aspiration pneumonia.