吞咽功能评估表联合康复锻炼对脑卒中吞咽障碍患者肺部感染的影响

Effect of swallowing function assessment scale combined with rehabilitation exercise on pulmonary infections in stroke patients complicated with dysphagia

目的探讨吞咽功能评估表联合康复锻炼对脑卒中吞咽障碍患者肺部感染的影响。方法选取2013年6月-2016年6月在医院神经科住院治疗的脑卒中合并吞咽功能障碍的患者158例作为研究对象,根据随机数字表法将患者分为传统治疗组和联合治疗组,每组79例,传统治疗组给予常规干预,联合治疗组给予吞咽功能评估表联合康复锻炼,干预一个月后,比较两组患者的肺部感染率,病原菌分布,吞咽功能评价,生活质量和满意度。结果联合治疗组患者的感染率低于传统治疗组,17例感染患者共检出病原菌22株,以革兰阴性菌为主占63.6%,革兰阳性菌占31.8%,真菌占4.5%;联合治疗组患者的治愈例数和有效率均显著高于传统治疗组,差异有统计学意义(P<0.05);联合治疗组患者生理领域、环境领域、心理领域、社会领域以及生存质量总分均高于传统治疗组,差异有统计学意义(P<0.05)。结论将吞咽功能评估表联合康复锻炼应用于脑卒中合并吞咽功能障碍的患者中可以降低肺部感染率,改善吞咽功能障碍,提高生存质量。

OBJECTIVE To explore the effect of swallowing function assessment scale combined with rehabilitation exercise on pulmonary infections in stroke patients complicated with dysphagia.METHODS A total of 158 stroke patients complicated with dysphagia who were hospitalized for treatment in neurology department from Jun 2013 to Jun 2016 were enrolled in the study and randomly divided into the traditional treatment group and the combined treatment group,with 79 cases in each group,the traditional treatment group was given conventional intervention,while the combined treatment group was treated with swallowing function assessment scale combined with rehabilitation exercise.The incidence of pulmonary infection,distribution of pathogens,swallowing function,quality of life and satisfaction were observed and compared between the two groups of patients after the intervention for one month.RESULTS The infection rate of the combined treatment group was lower than that of the traditional treatment group.Totally 22 strains of pathogens were isolated from 17 patients with infections,of which 63.6% were gram-negative bacteria,31.8% were gram-positive bacteria,and 4.5% were fungi.The number of cured cases and effective rate of treatment were higher in the combined treatment group than in the traditional treatment group（P〈0.05）.The total score of physiology score,environment score,psychology field,society field and quality of life was significantly higher in the combined treatment group than in the traditional treatment group（P〈0.05）.CONCLUSIONThe swallowing function assessment scale combined with rehabilitation exercise may reduce the incidence of pulmonary infections,improve the dysphagia and raise the quality of life of the stroke patients complicated with dysphagia.