吞咽运动操对卒中后吞咽障碍患者的临床疗效 |
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引用本文: | 陈妙,余梅,周荣,黄祖秀,林书阳,陈炳. 吞咽运动操对卒中后吞咽障碍患者的临床疗效[J]. 中国现代医生, 2023, 61(10): 6-9+22 |
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作者姓名: | 陈妙 余梅 周荣 黄祖秀 林书阳 陈炳 |
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作者单位: | 浙江中医药大学附属温州中医院神经内科,浙江温州 325000;;浙江中医药大学附属温州中医院康复治疗部,浙江温州 325000 |
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基金项目: | 浙江省中医药科技计划项目(2020ZB239);温州市科技项目(Y20190044) |
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摘 要: | 目的 探讨吞咽运动操对卒中后吞咽障碍患者的临床疗效。方法 选取2019年7月至2021年6月浙江中医药大学附属温州中医院收治的卒中后吞咽障碍患者120例,采用随机数字表法将其分为对照组和运动组,每组各60例。对照组患者给予神经肌肉电刺激和吞咽摄食行为指导,运动组患者在此基础上增加吞咽运动操锻炼。两组患者治疗前后均进行荧光吞咽造影检查(video fluoroscopic swallowing study,VFSS),并使用吞咽量表评定吞咽功能,比较治疗4周后两组患者的临床疗效、拔管情况和卒中相关性肺炎(stroke associated pneumonia,SAP)发生率。结果 治疗后,两组患者的吞咽功能性交流测试(functional communication measure,FCM)评分、VFSS各期评分及总分均显著高于本组治疗前,渗透-误吸量表(penetration-aspiration scale,PAS)评分显著低于本组治疗前(P<0.05);运动组患者的FCM评分、口腔期、误咽及VFSS总分均显著高于对照组,PAS评分显著低于对照组(P<0.05)。治疗后,...
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关 键 词: | 卒中 吞咽障碍 吞咽运动训练 吞咽康复 |
Clinical effect of swallowing exercise on patients with dysphagia after stroke |
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Abstract: | Objective To investigate the clinical effect of swallowing exercise on patients with dysphagia after stroke. Methods A total of 120 patients with dysphagia after stroke admitted to Zhejiang University of Traditional Chinese Medicine Affiliated Wenzhou Hospital from July 2019 to June 2021 were selected and divided into control group and exercise group by random number table method, with 60 cases in each group. Patients in control group were given neuromuscular electrical stimulation and swallowing behavior guidance, patients in exercise group were given swallowing exercise training on this basis. Video fluoroscopic swallowing study (VFSS) was performed before and after treatment in both groups, and swallowing function was evaluated by swallowing scale. Clinical efficacy, extubation and incidence of stroke associated pneumonia (SAP) were compared between the two groups after 4 weeks of treatment. Results After treatment, functional communication measure (FCM) score, VFSS score and total score in two groups were significantly higher than before treatment, while penetration-aspiration scale (PAS) score was significantly lower than before treatment (P<0.05). The score of FCM, oral stage, misswallow and VFSS in exercise group were significantly higher than those in control group, while PAS score was significantly lower than that in control group (P<0.05). After treatment, the total effective rate and extubation rate of exercise group were significantly higher than those of control group (P<0.05), and the incidence of SAP was significantly lower than that of control group (P<0.05). Conclusion Swallowing exercise can improve the swallowing function of convalescent stroke patients, reduce the incidence of SAP and improve the quality of life. |
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