吞咽治疗仪联合肠内营养治疗卒中后延髓麻痹吞咽障碍的临床研究

目的观察吞咽治疗仪联合肠内营养支持对卒中后延髓麻痹咽期神经源性吞咽障碍患者的治疗效果。方法选取咽期吞咽障碍患者106例随机分为对照组、治疗仪组、肠内营养组及联合治疗组。各组患者均给予脑卒中常规药物治疗及鼻饲营养师指导下配制的匀浆流质饮食,治疗仪组患者同时辅以吞咽治疗仪治疗,肠内营养组患者则以肠内营养制剂瑞高治疗,联合治疗组患者则同时辅以吞咽治疗仪及肠内营制剂瑞高联合治疗。分别于治疗前、后采用反复唾液吞咽测试及饮水试验评价患者吞咽功能的改善情况。结果除对照组患者以外,其他各组患者吞咽功能评分均较治疗前显著改善（P〈0.01）,进一步分析后发现,各组患者吞咽功能疗效顺序如下：联合治疗组〉治疗仪组〉肠内营养组〉对照组,差异均有统计学意义（P〈0.01）。结论吞咽治疗仪联合肠内营养治疗脑卒中后延髓麻痹所导致的吞咽障碍具有协同效应,可进一步提高临床疗效,促进患者早日康复。

Clinical Studies of swallowing treatment apparatus combined with enteral nutrition in the treatment of dysphagia caused by bulboparalysis after stroke

Objective To observe the effectiveness of swallowing treatment apparatus combined with enteral nutrition in the treatment of dysphagia caused by bulboparalysis after stroke. Methods One hundred and six patients were randomly divided into control group,apparatus group,enteral nutrition group and combined treatment group. All the patients were given routine medication treatment. In addition,the patients in apparatus group and enteral nutrition group were given swallowing treatment apparatus therapy and enteral nutrition therapy,respectively. The patients in combined treatment group were given swallowing treatment apparatus therapy combined with enteral nutrition. Repetitive saliva swallowing test and water drinking test were used to assess swallowing function before and 21 st d after treatment. Results It was shown that the patients in all groups but the control group got significant improvement in swallowing after treatment,as demonstrated by the swallowing function scores（ P 0. 01） . Moreover,the priority order in improvement of swallowing function and recovering rate were： combined treatment grouP apparatus grouP enteral nutrition grouP control group（ P 0. 01） . Conclusion The combination of swallowing treatment apparatus therapy and enteral nutrition could act synergically to ameliorate dysphagia caused by bulboparalysis after stroke and help patients recover soon.