间歇经口胃管结合“舌三针”治疗急性脑卒中后吞咽障碍的临床观察

Clinical Efficacy of Intermittent Orogastric Tube Placement Combined with "Tongue Triple Acupuncture" in Treatment of Dysphagia After Acute Stroke

目的探讨间歇经口胃管结合舌三针治疗急性脑卒中患者吞咽障碍的临床疗效。方法将入选的90例由急性脑卒中引起的吞咽障碍患者随机分为口胃管组、针刺组和口胃管针刺组,每组30例,其中口胃管组采用间歇经口胃管置管干预,针刺组采用舌三针(上廉泉、左右旁廉泉)治疗方法干预,口胃管针刺组采用间歇经口胃管置管法结合舌三针治疗,干预7 d后分别对患者的吞咽功能、并发症发生情况及生活质量状况进行评估。结果口胃管针刺组患者吞咽功能总有效率及生活质量各维度评分均高于口胃管组和针刺组,差异有统计学意义(P<0.05),口胃管组和针刺组无明显差异(P>0.05);口胃管针刺组并发症发生情况低于口胃管组和针刺组,差异有显著统计学意义(P<0.01),而口胃管组较针刺组相比,并发症发生率更低(P<0.05)。结论间歇经口胃管结合舌三针治疗具有协同作用,对急性脑卒中患者吞咽障碍的康复有良好疗效,并能有效改善患者生活质量,降低并发症的出现,值得在临床护理中推荐实施。

Objective To explore the clinical efficacy of intemittent orogastric tube placement combined with tongue triple acupuncture in the treatment of dysphagia in patients with acute stroke. Methods A total of 90 patients with dysphagia caused by acute stroke were randondy divided into orogastric tube group, acupuncture group, and orogastric tube plus acupuncture group, with 30 cases in each group. The orogastric tube group, acupuncture group, and orogastric tube plus acupuncture group were treated by intemittent orogastrie tube placement, tongue triple acupuncture （superior Lianquan point ancl bilateral Lianquan points）, and intermittent orogastric tube placement combined with tongue triple acupuncture, respectively. Alter seven day-s of treatment, the patients were assessed for swallowing function, complications, and quality- of life. Results Compared with the orogastrie tube group and acupuncture group, the orogastrie tube plus acupuncture group had significantly higher overall rate of improvement in swallowing funetion and scores for all dimensions of quality- of life （P〈0.05）, and a significantly lower incidence rate of complications （P〈0.01）. The incidence rate of complications was significantly lower in the orogastrie tube group than in the acupuncture group （P〈0.05）, while there were no significant differences between the two groups in the overall rate of improvement in swallowing function and scores for all dimensions of quality- of life （P〉0.05）. Conclusion There is a synergistic effect when intermittent orogastrie tube placement is combined with tongue triple acupuncture, which shows a good therapeutic effect on dysphagia in patients with acute stroke. Meanwhile, it can efteetively improve the quality of life of patients and reduce the incidence rate of complications. Therefore, it holds promise for use in clinical nursing.