康复训练对脑卒中后吞咽障碍及吸入性肺炎发生率的影响研究

Effect of rehabilitation training on the incidence of dysphagia and aspiration pneumonia in patients with stroke

目的探讨康复训练对脑卒中后吞咽困难吞咽功能障碍以及吸入性肺炎发生率的影响。方法选取2017年5月至2018年5月福建省南平市第一医院收治的96例脑卒中后吞咽困难患者作为研究对象,采用随机数字表法将其分为参照组和研究组,每组各48例。参照组患者采用常规康复治疗,研究组患者则在参照组的基础上采用综合性的康复训练。比较2组患者的吞咽困难的治疗效果,采用吞咽X线电视透视检查(VFSS)评分比较2组患者治疗前后的吞咽功能障碍改善情况,并观察比较2组患者吸入性肺炎的发生情况。结果研究组吞咽困难治疗的有效率为89.58%,参照组吞咽困难治疗的有效率为72.92%,研究组治疗的有效率高于参照组,差异具有统计学意义(P<0.05)。治疗前,2组吞咽功能VFSS评分比较差异无统计学意义(P>0.05)。治疗后,2组吞咽功能VFSS评分均有明显高于治疗前,差异有统计学意义(P<0.05)。而研究组治疗后的吞咽功能VFSS评分高于参照组,差异有统计学意义(P<0.05)。研究组患者的吸入性肺炎发生率为4.17%,明显低于参照组的18.75%,差异有统计学意义(P<0.05)。结论脑卒中后吞咽困难患者采用综合康复训练能有效改善患者的吞咽功能障碍情况,提高治疗效果,并降低吸入性肺炎的发生几率,值得临床推广应用。

Objective To investigate the effect of rehabilitation training on dysphagia and the incidence of aspiration pneumonia in patients with dysphagia after stroke. Methods From May 2017 to May 2018, 96 patients with dysphagia after stroke were selected as the objects of study. They were divided into control group(n=48) and research group(n=48) according the random digital table method. The patients in the reference group were treated with routine rehabilitation, while the patients in the research group were treated with comprehensive rehabilitation training on the basis of the reference group. The therapeutic effect of dysphagia in the two groupse were valuated and compared, and the improvement of dysphagia before and after treatment with the(VFSS) score of swallowing X-ray fluoroscopy were compared. And the incidence of aspiration pneumonia were observed and compared between the two groups.Results The effective rate of dysphagia in the research group was 89.58%, and the effective rate of dysphagia in the control group was 72.92%. The effective rate in the research group was higher than that in the control group(P<0.05). Before treatment, there was no significant difference in VFSS score of swallowing function between the two groups(P>0. 05). After treatment, the VFSS scores of swallowing function in the two groups were significantly higher than those before treatment(P<0.05). The VFSS score of swallowing function in the research group was significantly higher than that in the control group(P<0.05). The incidence of aspiration pneumonia in the research group was 18.75%, which was significantly lower than that in the control group(4.17%), the difference was statistically significant(P<0.05). Conclusion Comprehensive rehabilitation training in patients with dysphagia after stroke can effectively improve the condition of dysphagia, improve the therapeutic effect and reduce the incidence of aspiration pneumonia, which is worthy of clinical application.