不同干预措施对急性脑梗死患者吞咽障碍的影响

Effects of early intervention on swallowing function of patients with dysphagia following acute cerebral infarction

目的探讨不同干预措施对急性脑梗死患者吞咽障碍的影响。方法将115例急性脑梗死后吞咽障碍患者随机分成3组,其中42例为综合治疗组(康复训练联合针刺治疗),36例为康复训练组,37例为针刺治疗组。分别于治疗前、治疗2周后采用洼田饮水试验、洼田吞咽能力分级以及血氧饱和度测定,进行吞咽功能评估。结果治疗前3组间洼田饮水试验分级以及3组间基线SpO2值和饮水试验后SpO2最小值比较差异均无统计学意义(P>0.05)。治疗2周后3组洼田饮水试验分级均较治疗前明显改善,差异有统计学意义(P<0.05);综合治疗组的饮水试验及洼田吞咽能力疗效评价结果均显著好于康复训练组和针刺治疗组,差异均有统计学意义(P<0.05);综合治疗组基线值和饮水试验后SpO2最小值提高均优于康复训练组和针刺治疗组,差异均有统计学意义(P<0.05)。结论早期康复训练联合针刺的综合治疗优于单一的康复训练或针刺治疗,能明显改善患者的吞咽障碍,促进吞咽功能恢复,减少误吸。

Objective To study the effect of early intervention on swallowing function in patients with dysphagia following acute cerebral infarction.Methods 115 patients with dysphagia caused by acute cerebral infarction were randomly divided into 3 groups： a comprehensive treatment group（42 patients with received rehabilitation training,acupuncture and routine drug）,a rehabilitation group（36 patients with received comprehensive rehabilitation training and routine drug）,and acupuncture group（37 patients with received acupuncture therapy and routine drug）.The swallowing function of all patients was evaluated with Water-Swallow Test,clinical curative effect assessment and the arterial oxygen saturation（SpO2）.Results After treatment,the Water-Swallow Test scores of 3 groups were significantly higher than those before treatment（P0.05）.The Water-Swallow Test scores and the cure rate of the comprehensive treatment group were higher than those of other two groups（P0.05）.After treatment,the baseline SpO2 and post-water swallowing SpO2 of the comprehensive treatment group were significantly higher than those of other two groups（P0.05）.Conclusion Early rehabilitation training combined with acupuncture may improve swallowing function significantly of patients with acute cerebral infarction.