脑卒中合并吞咽困难的早期评估及治疗

Early assessment and treatment in acute stroke patients with dysphagia

目的观察脑卒中合并吞咽困难的发病率、早期标准吞咽功能评估方法及治疗效果。方法对132例急性脑卒中患者进行早期标准吞咽功能评估,选择其中56例合并吞咽困难患者随机分成治疗组和对照组。治疗组根据评估情况选择综合治疗措施,对照组按照常规治疗,治疗时间为4周,以治疗前后吞咽功能恢复情况及吸入性肺炎发生率作为观察指标。结果急性脑卒中后吞咽困难发生率为52%,治疗组吞咽功能恢复率显著高于对照组,治疗组吸入性肺炎发生率明显低于对照组。结论吞咽困难是脑卒中急性期最常见的问题,对这类患者进行早期标准吞咽功能评估,并及时干预能有效促进吞咽功能恢复,降低吸入性肺炎的发生率。

Objective To investigate the incidence of dysphagia in acute stroke patients and the method of early swallowing assessment and the therapeutic effect iveness. Methods 132 patients with acute stroke received early standardized swallowing assessment（SSA） within the first 24 hours after admission. Fifty-six dysphagia patients were divided into treatment group and control group. The treatment group received combination treatment based on assessment results, while the control group received conventional treatment;both groups were treated for 4 weeks. The recovery of swallowing fimction and incidonce of aspiration pneumonia were compared betwecn the two groups. Results The incidence of post-stoke dysphagia was 52%. The recovery rate of swallowing hmction in the treatment group was significantly higher than that in the control group. The incidence of aspiration pneumonia in the treatment group was significantly lower than that in the control group. Condusions Dysphagia is a common problem in acute stroke patients. Early standardized swallowing assessment and imtervention in time can improve siganificantly the swallowing fimction and reduce the incidence of aspiration pneumonia.