文章摘要
徐新平,孙洁,张蒙蒙,吴迎迎.卒中后认知障碍程度对摄食-吞咽功能影响的临床研究[J].中国康复,2020,35(11):568-571
卒中后认知障碍程度对摄食-吞咽功能影响的临床研究
Effect of the degree of cognitive impairment on ingestion-swallowing function after stroke
  
DOI:
中文关键词: 认知功能障碍程度  摄食-吞咽障碍  摄食-吞咽功能
英文关键词: Degree of cognitive impairment  Ingestion swallowing disorder  Ingestion swallowing function
基金项目:徐州市科技局社会发展项目基金资助(KC18190)
作者单位
徐新平 蚌埠医学院研究生院安徽蚌埠 233000 
孙洁 1.蚌埠医学院研究生院安徽蚌埠 2330002.徐州市中心医院新城康复科江苏徐州 221000 
张蒙蒙 徐州医科大学江苏徐州 221000 
吴迎迎 蚌埠医学院研究生院安徽蚌埠 233000 
摘要点击次数: 628
全文下载次数: 345
中文摘要:
      目的:研究脑卒中后认知障碍程度对摄食-吞咽功能的影响。方法:选取脑卒中后认知障碍患者60例,根据蒙特利尔认知评估量表(MOCA)将入组患者分为轻、中、重度3组。根据电视透视吞咽造影检查(VFSS)结果及24h入量,筛选并统计各组中存在摄食-吞咽障碍的患者,比较3组患者摄食-吞咽障碍发生率。同时,对三组患者进行认知-摄食训练,训练周期为8周,以24h入量、吞咽障碍造影评分量表(VDS)得分、口腔运送时间(OTT),软腭上抬时间(SET)为评定标准,比较各组摄食-吞咽障碍患者训练前后的摄食-吞咽功能。结果:经统计学分析,3组患者摄食-吞咽障碍的发生率不同(P<0.05),重度认知障碍患者更易发生摄食-吞咽障碍。训练后组内比较,中重度认知障碍患者的24h入量、VDS分值、OTT、SET均较前改善(P<0.05),轻度患者的24h入量、OTT也较前有所改善(P<0.05);组间比较,训练前重度认知障碍患者的24h入量、VDS分值、OTT较轻、中度组差(P<0.05),轻度患者的SET较中重度组好;训练后,轻度组相关摄食-吞咽功能指标结果最佳(P<0.05);轻中度组较重度组指标改善更显著,差异有统计学意义(P<0.05)。结论:认知障碍程度对卒中后患者的摄食-吞咽功能及康复治疗效果存在显著影响。认知障碍程度越重,摄食-吞咽障碍发生率越高,且患者的摄食-吞咽功能越差;认知障碍程度越轻,摄食-吞咽功能改善越明显。
英文摘要:
      Objective: To study the effect of cognitive impairment on food intake and swallowing function after stroke. Methods: From September 2018 to December 2019, 60 patients with post-stroke cognitive impairment who were hospitalized in the Department of Neurology and Rehabilitation of our hospital were selected and divided into three groups according to the Montreal Cognitive Assessment (MOCA). According to the results of video fluoroscopy swallowing study (VFSS) and 24-h intake, the patients with dysphagia were screened and counted, and the incidence of dysphagia was compared among the three groups. At the same time, three groups of patients were given cognitive feeding training for 8 weeks. The 24-h intake, the score of VDS, the oral transit time (OTT) and the soft palate elevation time (SET) were used as the evaluation standard to compare the feeding swallowing function before and after the intervention. Results: Statistically, the incidence of eating-swallowing disorder was significantly different among the three groups (P<0.05), and the patients with severe cognitive impairment were more likely to have eating-swallowing disorder. After training, the 24-h intake, VDS score, OTT and SET of patients with moderate and severe cognitive impairment were significantly improved (P<0.05), and the 24-h intake and OTT of patients with mild cognitive impairment were also significantly improved (P<0.05). The 24-h intake, VDS score and OTT of patients with severe cognitive impairment before training were significantly lower than those of patients with mild to moderate cognitive impairment (P<0.05). The SET in the mild group was better than that in the moderate severe group. After training, the results of related indexes of feeding and swallowing function in the mild group were the best (P<0.05). As compared with the severe group, the indexes in the mild to moderate group were improved significantly, and the difference was statistically significant (P<0.05). Conclusion: The degree of cognitive impairment has a significant impact on the food intake swallowing function and rehabilitation treatment effect in patients with stroke. The more severe the cognitive impairment, the higher the incidence of feeding-swallowing disorder and the worse the feeding-swallowing function of patients. The milder the degree of cognitive impairment, the more obvious the improvement of feeding-swallowing function.
查看全文   查看/发表评论  下载PDF阅读器  HTML
关闭
本刊微信二维码