呼吸肌功能锻炼联合吞咽功能训练在预防卒中患者相关性肺炎中的应用

Application of respiratory muscle function training combined with swallowing function training in preventing stroke-associated pneumonia

目的探讨呼吸肌功能锻炼联合吞咽功能训练在预防卒中相关性肺炎中的应用效果。方法选取2015年9月至2016年7月在本院治疗的急性脑卒中合并吞咽功能障碍者80例,根据随机数表法将患者等分为观察组和对照组。对照组患者依据情况选择降低颅内压、改善脑循环、营养脑神经等药物,同时给予肌电生物反馈治疗、运动疗法、作业疗法、物理因子治疗;观察组在对照组基础上进行呼吸肌功能锻炼合并吞咽功能训练,疗程均为1个月。分别在干预前、后记录两组患者SAP发生率、有效咳痰次数、排痰量及吞咽功能疗效评定。结果治疗后观察组卒中相关性肺炎的发生率显著低于对照组,差异比较有统计学意义(P<0.05)。观察组与对照组相比,有效咳痰次数和排痰量均有增加,差异有统计学意义(P均<0.05);观察组与对照组相比,吞咽功能总疗效有显著提高(P<0.05)。结论急性脑卒中合并吞咽障碍患者在常规治疗基础上进行呼吸肌功能锻炼联合吞咽功能训练,能明显降低卒中相关性肺炎的发生率。

Objective To explore the application effect of respiratory muscle function training combined with swallowing function training in preventing stroke-associated pneumonia. Methods To select 80 cases of patients with acute stroke complicated with swallowing dysfunction who were treated in our hospital from September 2015 to July 2016 as research subjects,and they were randomly divided into observation group and control group according to the random number table method. The patients in the control group chose drugs to reduce intracranial pressure,improve cerebral circulation,and provide nutrient for brain according to the situation. Meanwhile,patients were treated with electromyographic biofeedback therapy,exercise therapy,occupational therapy,and physical factor therapy. The observation group was received respiratory muscle function exercise with swallowing function training on the basis of the control group,and the treatment was for 1 month. Before and after the intervention,the incidence of SAP,the number of effective expectoration,the amount of sputum,and the evaluation of swallowing function of the patients in the two group were recorded. Results The incidence of stroke-associated pneumonia in the observation group was significantly lower than that in the control group after treatment,and the difference was statistically significant（P 〈 0. 05）. Compared with the control group,the number of effective expectoration and sputum volume in the observation group increased,and the difference was statistically significant（all P 〈 0. 05）. Compared with the control group,the total effect of swallowing function was significantly improved in the observation group（P 〈 0. 05）. Conclusion Patients with acute stroke complicated with dysphagia undergoing respiratory muscle function training combined with swallowing function training on the basis of routine treatment can significantly reduce the incidence of stroke-associated pneumonia.