联合口肌生物反馈法与常规药物及康复法治疗急性脑梗死后吞咽障碍的效果比较

Comparison of effects between combined oral muscle biofeedback and conventional drugs and rehabilitation in the treatment of dysphagia after acute cerebral infarction

目的评价比较联合口肌生物反馈法与常规药物及康复治疗法治疗急性脑梗死后吞咽障碍的效果。方法选取我院2016年1月~2018年1月收治的急性脑梗死后吞咽障碍患者94例,随机分为对照组与观察组,每组47例。对照组患者接受药物治疗及常规康复锻炼,观察组患者联合口肌生物反馈治疗。比较两组患者治疗前后洼田饮水试验、标准吞咽功能(SSA)评分以及吞咽障碍相关的生活质量评价表(SWAL-QOL),评价综合临床疗效并记录并发症发生情况。结果观察组治疗总有效率为89.36%,对照组为78.72%,观察组的治疗总有效率显著高于对照组,差异具有统计学意义(P<0.05);与治疗前相比较,两组患者治疗后洼田饮水试验均显著改善,且观察组治疗后效果优于对照组,差异具有统计学意义(P<0.05);两组治疗后SSA评分显著降低、SWAL-QOL评分显著升高,且观察组治疗后SSA和SWAL-QOL评分与对照组相比较,差异具有统计学意义(P<0.05);观察组误咽、肺部感染、吸入性肺炎发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论在常规药物及康复锻炼的基础上联合口肌生物反馈治疗能显著改善急性脑梗死后吞咽障碍患者吞咽功能,提高生活质量,减少误吸、吸入性肺炎等并发症。

Objective To compare the effect between combined oral muscle biofeedback and conventional drugs and rehabilitation in the treatment of dysphagia after acute ischemic cerebral infarction. Methods Ninety-four patients with dysphagia after acute cerebral infarction admitted to our hospital from January 2016 to January 2018 were randomly divided into the control group and the observation group, with 47 cases in each group. Patients in the control group received medication and routine rehabilitation exercises, and patients in the observation group received combined oral muscle biofeedback treatment. The Putian drinking test, the standard swallowing function(SSA) score, and the dysphagia-related quality of life evaluation form(SWAL-QOL) were compared between the two groups before and after treatment. The comprehensive clinical efficacy was evaluated and the complications were recorded. Results The total effective rate was 89.36% in the observation group and 78.72% in the control group. The total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P<0.05). Before the treatment, the Putian drinking water in the two groups was significantly improved compared with after treatment. And the observation group was better than the control group after treatment. The difference between the two groups was statistically significant(P<0.05). After treatment, the SSA scores were significantly lower and the SWAL-QOL scores were significantly higher. The SSA and SWAL-QOL scores in the observation group were significantly higher than those in the control group(P<0.05);the incidence of aspiration, pulmonary infection and aspiration pneumonia in the observation group was significantly lower than that in the control group, the difference was statistically significant(P<0.05). Conclusion Combined with oral muscle biofeedback therapy based on drug therapy and routine rehabilitation exercise can significantly improve swallowing function, improve quality of life, and reduce complications such as aspiration and aspiration pneumonia in patients with dysphagia after acute cerebral infarction.