肝豆状核变性患者构音障碍的康复护理

Rehabilitation nursing research of hepatolenticular degeneration patients with dysarthria

目的探讨肝豆状核变性患者构音障碍康复护理的疗效及其临床应用价值。方法将136例肝豆状核变性构音障碍患者随机分为康复护理组和常规护理组各68例，均采用二巯基丙磺酸钠正规驱铜治疗，常规护理组患者给予一般护理，康复护理组患者给予一般护理和构音障碍康复护理。治疗8周后，通过Frenchay构音障碍评定法、型喉发声空气力学分析仪、肺功能检测仪、ADL量表及WHOQOL—BREF进行疗效评定并比较。结果康复护理组治疗后构音障碍评定总有效率为95．6％，对照组为72．1％，两组疗效比较差异有统计学意义（χ2=13．88，P〈0．01）；康复护理组治疗前后MPT比较差异有统计学意义[（6．12±5．36）s比（8．94±6．43）s，t=2．78，P〈0．01]，FVC治疗前后比较差异有统计学意义（t=2．46，P〈0．05）；两组治疗后MPT、FVC比较差异均有统计学意义（P〈0．05）；康复组治疗后Barthel指数为（68．34±6．35）分，对照组为（60．81±5．44）分，两组疗效比较差异有统计学意义（t=7．43，P〈0．01）；康复组治疗前后WHOQOL—BREF测定结果比较差异有统计学意义（P〈0．01），两组治疗后WHOQOL-BREF测定结果比较差异有统计学意义（P〈0．01或P〈0．05）。结论早期进行言语康复训练，可促进肝豆状核变性患者构音器官功能的恢复，改善患者的言语功能，提高其日常生活能力和生活质量，具有较高的临床应用价值。

Objective To explore the efficacy and the clinical practice value of rehabilitation nursing to hepatolenticular degeneration patients with dysarthria. Methods 136 hepatolenticular degeneration patients with dysarthria in hospital were enrolled in this study, and they were randomly assigned to rehabilitation nursing group and usual nursing group. Both groups were treated formally by sodium dimercaptosulphonate, the 68 patients of usual nursing group were given general nursing, the 68 patients of rehabilitation nursing group were given general nursing and rehabilitation nursing of dysarthria. Frenchay dysarthria measurement, Phonolaryngeal graph, Microspiro, Activity of Daily Living Scale and WHOQOL-BREF were used to evaluate and compare the therapeutic effect after 8 weeks. Results The total effect rate of rehabilitation nursing group was 95.6%, and usual nursing group was 72. 1%, and the difference was significant （ χ2 = 13. 88, P 〈 0. 01 ）. MPT in rehabilitation nursing group was different before and after treatment [ （ 6.12 ± 5.36 ） s vs （ 8.94±6.43 ） s, t = 2.78, P〈0.01] and FVC was also different （t =2.46, P〈0.05）. The MPT and FVC in the two group were different （P 〈 0. 01 ）. WHOQOL-BREF results have reach the statistically significance in the two group after treatment （P 〈 0. 01 or P 〈 0. 05 ）. Conclusions Dysarthria is a common language barrier of hepatolenticular degeneration ; it seriously affects the physical and mental health of patients. Early speech rehabilitation training, with the treatment of hepatolenticular degeneration patients by sodium dimercaptosulphonate, can greatly promote sound organ function recovery, can obviously improve the speech function of patients and can improve daily life ability and the life quality of them, it has high value of clinical applications.