舌压抗阻反馈训练联合穴位按摩在脑卒中后吞咽障碍患者中的应用效果

Effect of Tongue Pressure Resistance Feedback Training Combined with Acupoint Massage in Patients with Dysphagia after Stroke

目的探讨舌压抗阻反馈训练联合穴位按摩在脑卒中后吞咽障碍患者中的应用效果.方法选择如皋博爱医院2018年1月—2022年12月收治的62例脑卒中后吞咽障碍患者为研究对象,以随机数字表法将其分为对照组及观察组.对照组(n=31)采用常规康复护理,观察组(n=31)在此基础上采用舌压抗阻反馈训练联合穴位按摩干预.比较两组患者的吞咽功能、摄食能力、舌压及并发症发生情况.结果干预后,观察组的洼田饮水试验分级、标准吞咽功能评定量表评分、Rosenbek渗透/误吸量表评分分别为(1.68±0.31)级、(20.39±3.75)分、(2.46±0.47)分,均低于对照组,组间差异有统计学意义(P<0.05).干预后,观察组的功能性经口摄食量表评分为(5.42±0.52)分,高于对照组,差异有统计学意义(P<0.05).干预后,观察组的舌压峰值、舌压平均值分别为(53.05±5.35)kPa、(46.64±5.40)kPa,均高于对照组,舌压持续时间为(17.18±2.11)s,长于对照组,组间差异有统计学意义(P<0.05).观察组的并发症发生率为6.45%,低于对照组的25.81%,差异有统计学意义(P<0.05).结论脑卒中后吞咽障碍患者采用舌压抗阻反馈训练联合穴位按摩能提高吞咽功能与摄食能力,有利于改善舌压,降低并发症发生风险,值得临床推广使用.

Objective To investigate the effect of tongue pressure resistance feedback training combined with acupoint massage in patients with dysphagia after stroke.Methods 62 patients with dysphagia after stroke admitted to Rugao Boai Hospital from January 2018 to December 2022 were selected as the study objects and were divided into a control group and an observation group by random number table method.The control group(n=31)was treated with routine rehabilitation nursing,and the observation group(n=31)was treated with tongue pressure resistance feedback training combined with acupoint massage on this basis.The swallowing function,feeding capacity,tongue pressure and complications were compared between the two groups.Results After the intervention,the Kubota water swallowing test degree,standardized swallowing assessment score and Rosenbek penetration-aspirationscale score in the observation group were(1.68±0.31)grades,(20.39±3.75)points and(2.46±0.47)points,respectively,which were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).After intervention,the functional oral intake scale score of the observation group was(5.42±0.52)points,which was higher than that of the control group,and the difference was statistically significant(P<0.05).After intervention,the peak value,average value in the observation group were(53.05±5.35)kPa,(46.64±5.40)kPa,respectively,which were higher than those in the control group,the duration of tongue pressure was(17.18±2.11)s,which was longer than that in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 6.45%,lower than 25.81%in the control group,the difference was statistically significant(P<0.05).Conclusion Tongue pressure resistance feedback training combined with acupoint massage can improve the swallowing function and feeding ability of patients with swallowing disorder after stroke,which is conducive to improving tongue pressure and reducing the risk of complications,and is worthy of clinical promotion.