| 杨涓,聂启鸿,邵银进,许志雄,熊晓文,付小琴.改变流质性状联合吞咽治疗对脑卒中吞咽障碍患者进食安全影响及治疗作用[J].中国康复,2018,33(6):468-471 |
| 改变流质性状联合吞咽治疗对脑卒中吞咽障碍患者进食安全影响及治疗作用 |
| The eating safety and the effects of changing fluidity features combined with swallowing treatment on post-stroke dysphagia |
| |
| DOI： |
| 中文关键词: 脑卒中 吞咽障碍 饮水呛咳 误吸 增稠 流质 |
| 英文关键词: stroke dysphagia drinking water-induced choking cough aspiration thickening liquid |
| 基金项目: |
|
| 摘要点击次数: 6478 |
| 全文下载次数: 4230 |
| 中文摘要: |
| 目的：观察改变流质性状联合吞咽治疗对脑卒中致吞咽障碍（饮水呛咳）患者的进食安全影响及治疗作用。方法：将80例脑卒中致饮水呛咳患者随机分为观察1组、观察2组、观察3组及对照组，每组20例。观察1组采用改变流质性状（增稠流质）治疗，观察2组采用吞咽治疗，观察3组采用改变流质性状（增稠流质）+吞咽治疗，对照组不改变流质性状、不行吞咽治疗。于治疗前、治疗1周、2周及4周（或治疗终点）时对各组患者行洼田饮水试验及才藤氏吞咽障碍分级评估，并对比各组患者的治愈率、肺部感染率、留置胃管率及治愈患者的治疗周期。结果：洼田饮水试验及才藤氏吞咽障碍评估显示：治疗2周、4周后，观察3组后一时间节点治愈率较前一时间节点有显著增加（P＜0.05），同时观察3组治愈率较对照组、观察1组及观察2组相同时间节点有显著增加（P＜0.05）；治疗4周后观察2组与对照组比较治愈率显著提高（P＜0.05）。治疗4周后，3个观察组肺部感染及留置胃管率较治疗前及对照组治疗后显著下降（P＜0.05），观察2组、观察3组痊愈率高于观察1组（P＜0.05），观察2组与观察3组比较差异无统计学意义；观察3组治愈患者平均治疗天数较观察1组、观察2组治愈患者平均治疗天数均有显著下降（P＜0.05）。结论:改变流质性状、吞咽治疗、改变流质性状联合吞咽治疗对脑卒中致饮水呛咳患者安全进食流质食物均有一定帮助作用，但改变流质性状联合吞咽治疗对于早期改善患者饮水呛咳、减少误吸及肺部感染、保证患者安全进食流质食物有显著效果，并能明显改善患者的吞咽功能、缩短治疗周期。 |
| 英文摘要: |
| Objective: To observe the eating safety and the effects of changing fluidity features combined with swallowing treatment on post-stroke dysphagia (drinking water induced choking cough). Methods: Eighty patients with drinking water-induced choking cough resulting from stroke were randomly divided into experiment group 1, experiment group 2, experiment group 3 and control group, with 20 patients in each group. Patients in the experiment group 1 received changing the fluidity feature (thickening fluids) treatment, those in the experiment group 2 received swallowing treatment, those in the experiment groups 3 received changing the fluidity feature (thickening liquid) + swallowing treatment, and those in control group did not receive changing liquid feature and swallowing treatment. Drinking water test and the swallowing function classification were used to assess the swallowing function respectively before treatment and at 1st, 2nd and 4th week after treatment (or the end of treatment). The curative rate, lung infection rate, indwelling gastric tube rate and the average treatment days of patients cured were compared. Results: Drinking water test and the swallowing function classification showed that the curative rate was higher at next time point than that at the previous time point in experiment group 3 at 2nd and 4th week after treatment (P<0.05). The curative rate was significantly increased in experiment group 3 as compared with that in control group and experiment group 1 and experiment group 2 at the same time point (P<0.05). The curative rate was significantly higher in experiment group 2 than in control group at 4th week after treatment (P<0.05). The rates of lung infection and indwelling gastric tube in the experiment groups were significantly lower after treatment than those before treatment and in control group after treatment (P<0.05). The curative rate in experiment group 2 and experiment group 3 was significantly higher than that in experiment group 1 (P<0.05). There was no significant difference between experiment group 2 and experiment group 3. As compared with the experiment groups 1 and 2, the average treatment days were significantly shortened in experiment group 3 (P<0.05).Conclusion: Changeing liquid feature, swallowing treatment, or changing liquid feature combined with swallowing therapy all have a certain helpful to eat liquid food safely for patients with post-stroke dysphagia, but the change of liquid features combined with swallowing therapy can not only improve drinking water induced choking cough early, reduce aspiration and pulmonary infection, guarantee the safety of patients to eat liquid food significantly, but also can improve the patient's swallowing function significantly and shorten the course of treatment. |
|
查看全文
下载PDF阅读器 HTML全文 |
| 关闭 |
|
|
|
