饮食干预结合吞咽训练对脑卒中吞咽障碍患者康复的对照研究

Comparative study of diet intervention combined with deglutition training for rehabilitation of patients with deglutition disorders after stroke

目的对照研究饮食干预结合吞咽训练对脑卒中吞咽障碍康复的疗效。方法选择脑卒中后吞咽障碍患者48例,按随机抽签分为对照组和观察组各24例。在常规治疗、护理、饮食宣教基础上,对照组予单纯吞咽训练,观察组予吞咽训练结合饮食干预,8周后使用洼田饮水试验、误吸率及白蛋白指标作为评价标准,观察两组的干预效果。结果干预后观察组患者洼田饮水试验评分较干预前显著下降(P<0.05),且观察组洼田饮水评分显著低于对照组(P<0.05);对照组患者洼田饮水试验评分亦有下降,但较观察组下降不明显;干预后观察组白蛋白指标无明显变化,对照组白蛋白指标明显下降;观察组发生误吸3例(3次),对照组发生误吸5例(8次)。结论脑卒中吞咽障碍患者行饮食干预结合吞咽训练较单纯吞咽训练的康复作用更明显。

Objective To make comparative study on diet intervention combined with deglutition training for rehabilitation of patients with deglutition disorders after stroke.Method Divide 48 patients with deglutition disorders after stroke into observation group（n=24）and control group（n=24）randomly.All patients receive routine treatment,nursing care and diet education.Patients in control group receive single deglutition training.Patients in observation group receive diet intervention combined with deglutition training.Observe the intervention effect of two groups by bedside water-swallowing test,aspiration rate and albumin index 8weeks later.Result Score on bedside water-swallowing test of patients in observation group is significantly reduced after intervention（P〈0.05）.Score on bedside water-swallowing test is obviously lower in observation group than in control group（P〈0.05）.Score on bedside water-swallowing test of patients in control group is reduced,which is not significant.Albumin index in observation group has no obvious change after intervention,which is changed obviously in control group.There are 3cases（3times）of aspiration in observation group and 5cases（8times）in control group.Conclusion Diet intervention combined with deglutition training has better rehabilitation effect than single deglutition training for patients with deglutition disorders after stroke.