文章摘要
张秋,王玉龙,方锐,李小萍,温贤达,王玉珍,章静.脑卒中吞咽障碍患者早期行经皮内镜下胃造瘘术对康复效果的影响分析[J].中国康复,2019,34(9):461-464
脑卒中吞咽障碍患者早期行经皮内镜下胃造瘘术对康复效果的影响分析
Effect of percutaneous endoscopic gastrostomy on rehabilitation efficacy in patients with dysphagia after stroke
  
DOI:
中文关键词: 康复效果  脑卒中  经皮内镜下胃造瘘术  吞咽障碍
英文关键词: rehabilitation effect  stroke  percutaneous endoscopic gastrostomy  dysphagia
基金项目:
作者单位
张秋 深圳市第二人民医院康复医学科广东 深圳 518000 
王玉龙 深圳市第二人民医院康复医学科广东 深圳 518000 
方锐 深圳市第二人民医院康复医学科广东 深圳 518000 
李小萍 深圳市第二人民医院康复医学科广东 深圳 518000 
温贤达 深圳市第二人民医院康复医学科广东 深圳 518000 
王玉珍 深圳市第二人民医院康复医学科广东 深圳 518000 
章静 深圳市第二人民医院康复医学科广东 深圳 518000 
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中文摘要:
  目的:研究经皮内镜下胃造瘘术运用于脑卒中吞咽障碍中的价值。方法:选择60例脑卒中吞咽障碍患者,随机分为2组各30例,研究组经皮内镜下胃造瘘术后进行吞咽功能训练,对照组采取鼻胃管喂养下进行吞咽训练,治疗前后分别记录体质指数(BMI)、血清总蛋白、白蛋白及血红蛋白水平,并进行洼田饮水、吞咽功能评分(SSA),观察治疗1个月时患者拔管情况,并发症情况,观察消化道出血、吸入性肺炎及反流性食管炎的发生率。结果:治疗1个月后,2组BMI、血清总蛋白、白蛋白及血红蛋白水平与治疗前比较均明显提高(均P<0.05),研究组血清总蛋白、白蛋白及血红蛋白均明显高于对照组(P<0.05),但2组BMI水平比较无明显差异。 研究组并发症发生率明显低于对照组(P<0.05),拔管率高于对照组(P<0.05)。治疗后2组洼田饮水实验评分较治疗前明显提高(P<0.05),SSA评分较治疗前明显降低(P<0.05),且研究组2项评分改善程度明显优于对照组(P<0.05)。结论:早期经皮内镜下胃造瘘术应用于脑卒中吞咽障碍中效果明显,改善营养情况,减少并发症发生率,安全性高,提高吞咽功能,值得临床推广使用。
英文摘要:
  Objective: To study the value of percutaneous endoscopic gastrostomy in the treatment of dysphagia in stroke patients. Methods: Sixty patients with dysphagia following stroke were randomly divided into two groups according to the digital table method, 30 cases in each group. The study group received swallowing function training after percutaneous endoscopic gastrostomy, and the control group received swallowing training under nasogastric tube feeding. Body mass index (BMI), serum total protein, albumin and hemoglobin levels were recorded before and after the treatment. Standardized Swallow Assessment (SSA) was performed, the extubation and complications were observed at first month, and the incidence of digestive tract hemorrhage, aspiration pneumonia and reflux esophagitis was observed. Results: One month after treatment, the levels of BMI, serum total protein, albumin and hemoglobin in the two groups were significantly higher than those before treatment (P<0.05). The levels of serum total protein, albumin and hemoglobin in the study group were significantly higher than those in the control group (P<0.05), but there was no significant difference in BMI between the two groups. The incidence of complications in the study group was significantly lower than that in the control group (P<0.05), and the extubation rate was significantly higher in the study group than that in the control group (P<0.05). After treatment, the experimental scores of Watian drinking water in the two groups were significantly higher, and SSA scores were significantly lower than those before treatment (both P<0.05), and the improvement of the scores in the study group was significantly greater than that in the control group (P<0.05). Conclusion: Early percutaneous endoscopic gastrostomy has obvious effect on dysphagia following stroke, can improve nutritional status and quality of life, and reduce complications, and has high safety.
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