| 郑婵娟,夏文广,华强,张阳普,周元强.综合康复治疗对脑卒中后不同程度吞咽障碍的影响[J].中国康复,2012,27(6):420-422 |
| 综合康复治疗对脑卒中后不同程度吞咽障碍的影响 |
| Effects of comprehensive rehabilitation therapy on dysphagia of different degrees following stroke |
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| DOI： |
| 中文关键词: 脑卒中 吞咽障碍 综合康复治疗 电视透视吞咽功能检查 |
| 英文关键词: stroke dysphagia comprehensive rehabilitation therapy videofluoroscopic swallowing study |
| 基金项目:湖北省卫生厅科研项目（JX5B36） |
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| 中文摘要: |
| 目的：探讨综合康复治疗对脑卒中后不同程度吞咽障碍患者的临床疗效。方法：脑卒中患者124例采用洼田饮水试验进行吞咽障碍程度评定，分为轻度组58例、中度组50例和重度组16例，3组均给予吞咽功能训练、电刺激及针刺等综合康复治疗，治疗前后进行电视透视吞咽功能检查(VFSS)、美国国立卫生院卒中量表(NIHSS)、Hamilton抑郁量表(HAMD)及吞咽障碍特异性生活质量量表(SWAL-QOL)评定，并将吞咽障碍的严重程度与NIHSS、HAMD及SWAL-QOL评分进行相关性分析。结果：治疗4周后，轻度和中度组VFSS评分较治疗前明显提高(P＜0.01)，轻度及中度组痊愈率及总有效率均显著高于重度组，且轻度组痊愈率更高于中度组(P＜0.01,0.05)，2组总有效率比较差异无统计学意义。吞咽困难的严重程度与NIHSS评分无明显相关性(r=-0.103，P>0.05)，与HAMD评分有弱相关性(r=-0.562，P<0.05)，与SWAL-QOL评分有高度相关性(r=-0.715，P<0.05)。结论：综合康复治疗对脑卒中后轻、中度吞咽障碍疗效显著，重度吞咽障碍患者其吞咽功能的恢复较慢。 |
| 英文摘要: |
| Objective:To investigate the effects of comprehensive rehabilitation therapy on different degrees of dysphagia following stroke.Methods:A total of 124 stroke patients with dysphagia were divided into mild group (n=58),moderate group (n=50) and severe group (n=16) according to the WST.VFSS,NIHSS,HAMD and SWAL-QOL questionnaire were assessed before and after training.Correlation data analysis was conducted between severity of dysphagia and the scores of NIHSS,HAMD,SWAL-QOL.Results：After 4-week rehabilitation training,the scores of VFSS in mild or moderate dysphagia groups were increased,and the cure rate and total effective rate were higher than those in severe group,and that in mild group was higher than in moderate group(P<0.01,0.05).There were no significant differences of total effective rate between the two groups.VFSS scores were negatively correlated with HAMD (r=-0.562,P<0.05) and SWAL-QOL scores (r=-0.715,P<0.05),but not with NIHSS scores (r=-0.103,P>0.05).Conclusion：Rehabilitation training can obviously improve the swallow function of stroke patients with mild and moderate dysphagia,but not that much with severe dysphagia. |
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