文章摘要
熊虎,陈慧芳,史靖,徐伟健,肖小红,曾金明,冯俊芳,葛明,黄爱玲.吞咽障碍诊断系统早期评估下个体化吞咽治疗对脑卒中后吞咽障碍患者疗效的影响[J].中国康复,2019,34(11):571-574
吞咽障碍诊断系统早期评估下个体化吞咽治疗对脑卒中后吞咽障碍患者疗效的影响
Effect of individual swallowing therapy under early evaluation of dysphagia diagnosis system on patients with swallowing disorder after stroke
  
DOI:
中文关键词: 吞咽障碍诊断系统  早期评估  个体化吞咽治疗  脑卒中
英文关键词: dysphagia diagnosis system  early assessment  individual swallowing therapy  stroke
基金项目:宝山区医学特色专科和社区项目建设计划资助课题(BSZK-2018-B05)
作者单位
熊虎 上海中冶医院上海200941 
陈慧芳 上海中冶医院上海200941 
史靖 上海中冶医院上海200941 
徐伟健 上海中冶医院上海200941 
肖小红 上海中冶医院上海200941 
曾金明 上海中冶医院上海200941 
冯俊芳 上海中冶医院上海200941 
葛明 上海中冶医院上海200941 
黄爱玲 上海中冶医院上海200941 
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中文摘要:
      目的:通过吞咽障碍诊断系统早期评估和个体化吞咽治疗对脑卒中后吞咽障碍患者的治疗效果进行探讨。方法:选取脑卒中后吞咽功能障碍患者85例,随机分为对照组42例和观察组43例,所有患者给予脑卒中常规药物和康复治疗。对照组进行常规吞咽康复治疗,观察组根据吞咽障碍诊断系统评估结果采用个体化综合吞咽治疗,连续治疗8周,在治疗前后采用洼田饮水试验、标准吞咽功能评估(SSA)以及吞咽障碍特异性生活质量(SWAL-QOL)评分比较2组患者吞咽功能和生活质量改善情况,并记录误吸和吸入性肺炎等不良事件发生率。结果:治疗8周后,2组患者洼田饮水试验结果分级显示吞咽功能与治疗前比较均有显著提高(均P<0.01),且观察组患者洼田氏饮水试验结果优于对照组(P<0.01)。治疗8周后,2组患者的SSA评分较治疗前均明显降低(均P<0.01),SWAL-QOL评分较治疗前均明显提高(均P<0.01),且观察组患者SSA和SWAL-QOL评分较对照组改善更为显著 (均P<0.01)。治疗8周后,观察组患者不良事件发生率低于对照组(P<0.05)。结论:基于吞咽障碍诊断系统早期评估下个体化的综合吞咽治疗方案可以有效改善脑卒中后吞咽障碍患者的吞咽功能,减少误吸和吸入性肺炎的发生率,提高患者的生活质量。
英文摘要:
      Objective: To investigate the effect of individual swallowing therapy on patients with dysphagia after stroke through early assessment of the dysphagia diagnosis system. Methods: Eighty five patients with stroke and swallowing dysfunction were randomly divided into control group and observation group, 42 patients in control group and 43 patients in observation group. All patients were given conventional drugs and rehabilitation for stroke. The control group underwent routine swallowing rehabilitation treatment, and the observation group received individual swallowing treatment plan based on the evaluation results of the dysphagia diagnosis system. The treatment was continued for 8 weeks. Before and after treatment, the drinking water test, the standard swallowing function assessment (SSA) and swallowing quality of life (SWAL-QOL) scores were used to compare the improvement of swallowing function and quality of life between the two groups. The incidence of adverse events such as absorption and aspiration pneumonia was compared between the two groups. Results: After 8 weeks of treatment, the drinking water test and SWAL-QOL scores of the two groups were significantly improved as compared with those before treatment (all P<0.01), the SSA scores of the two groups was significanthy lower than those before treatment (allP<0.01), and the scores of the observation group were improved more significantly than those of the control group (all P<0.01). The incidence of adverse events was significantly lower in the observation group than in the control group (P<0.05). Conclusion: The individualized swallowing treatment plan based on early diagnosis of dysphagia diagnosis system can effectively improve the swallowing function of patients with dysphagia after stroke, reduce the incidence of absorption and aspiration pneumonia, and improve the quality of life of patients.
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