穴位按摩改善缺血性脑卒中急性期后吞咽功能障碍的疗效分析

Curative Effect of Acupressure on the Dysphagia after Acute Phase of Ischemic Stroke

目的探讨穴位按摩配合综合康复护理对缺血性脑卒中急性期后吞咽功能障碍患者的治疗效果。方法选取瑞金二路街道社区卫生服务中心2015年7月—2016年7月收治的缺血性脑卒中急性期后吞咽功能障碍患者120例,采用抽签法分为按摩组(60例)和对照组(60例)。两组患者均接受神经内科常规治疗和综合康复护理,包括直接训练、间接训练、心理护理与健康教育,90 d为1个疗程,连续3个疗程。同时,按摩组在此基础上选取翳风、廉泉、天突、太溪穴进行按摩,每日早晚各1次,90 d为1个疗程,连续3个疗程。结果对照组显效13例(21.7%)、有效29例(48.3%)、无效18例(30.0%);按摩组显效41例(68.3%)、有效14例(23.3%)、无效5例(8.3%),两组疗效比较,差异有统计学意义(u=5.069,P<0.05)。对照组营养不良、电解质紊乱发生率高于按摩组(P<0.05)。结论对缺血性脑卒中急性期后吞咽功能障碍患者进行穴位按摩配合综合康复护理,可明显改善患者吞咽功能并降低营养不良、电解质紊乱发生率。

Objective To discuss the curative effect of acupressure combined with rehabilitation nursing on the dysphagia after acute phase of ischemic stroke.Methods One hundred and twenty patients with dysphagia after acute phase of ischemic stroke admitted in Ruijin Second Road Community Health Service Center from July 2015 to July 2016 were selected as the participants,and divided into the acupressure group（n=60） and control group（n=60） by drawing lots.Both groups received the conventional neurology treatment and comprehensive rehabilitation nursing（direct swallowing training,indirect swallowing training,mental nursing and health education）,the acupressure group also received the acupressure treatment（massaging the acupoints of Yifeng,Lianquan,Tiantu and Taixi once daily in the morning and once daily in the evening）,for 3 courses of treatment（90-day treatment was considered as a course of treatment）.Results The dysphagia was improved more significantly in the acupressure group than in the control group（u=5.069,P〈0.05）,specifically,in the control group,the improvement of dysphagia was markedly excellent in 21.7%（13/60） of the patients,fair in 48.3%（29/60）,invalid in 30.0%（18/60）,while in the acupressure group,it was markedly excellent in 68.3%（41/60） of the patients,fair in 23.3%（14/60） and invalid in 8.3%（5/60）.The acupressure group had lower incidence rates of malnutrition and electrolyte disturbance than the control group（P〈0.05）.Conclusion For patients with dysphagia after acute phase of ischemic stroke,the treatment of acupressure and rehabilitation nursing can significantly improve the swallowing function,and reduce the incidence rates of malnutrition and electrolyte disturbance.