电针结合吞咽言语康复干预在假性球麻痹吞咽障碍中的应用

Application of Electroacupuncture Apparatus Combined with Swallowing Speech Rehabilitation Intervention in the Nursing of Patients with Dysphagia Caused by Pseudobulbar Palsy

目的:观察电针结合吞咽言语康复干预在假性球麻痹(PBP)吞咽障碍中的应用效果。方法:纳入2015年1月~2017年12月期间我院收治的脑中风后PBP患者88例,按照随机数字表分为观察组与对照组各44例,对照组进行常规康复干预,观察组在对照组之上,给予电针仪结合吞咽言语康复干预,连续干预4周后,比较两组吞咽功能、临床疗效、并发症发生情况及生活质量(SWAL-QOL评分)。结果:干预后,两组洼田饮水试验评分均显著低于干预前(P<0.05),藤岛一郎吞咽试验评分均显著高于干预前(P<0.05),且观察组降低或升高幅度大于对照组(P<0.05);观察组临床总有效率95.45%,显著高于对照组的75.00%(P<0.05);观察组并发症发生率2.27%,显著低于对照组的18.18%(P<0.05);两组SWAL-QOL吞咽症状维度、吞咽相关维度及普通维度各部分评分均显著高于治疗前(P<0.05),且观察组升高幅度大于对照组(P<0.05)。结论:电针仪结合吞咽言语康复用于PBP吞咽障碍患者护理中,可以改善患者吞咽功能,提高临床疗效,降低并发症发生,提升患者生活质量。

Objective: To observe the application effects of electroacupuncture apparatus combined with swallowing speech rehabilitation intervention in the nursing of patients with dysphagia caused by pseudobulbar paralysis ( PBP). Methods: 88cases of post-stroke PBP patients admitted to our hospital between January 2015and December 2017were included and divided into observation group and controlled group with 44cases in each group according to the random number table method. The ontrolled group was given routine rehabilitation intervention,and the observation group was given electroacupuncture apparatus combined with swallowing speech rehabilitation intervention based on the controlled group. After 4weeks of consecutive treatment,the swallowing function,clinical efficacy,occurrence of complications and quality of life ( SWAL-QOL score) were compared between the two groups. Results: After intervention,the score of water swallow test in the two groups was significantly lower than that before intervention ( P<0. 05),and the score of Ichiro Fujishima swallowing test was significantly higher than that before intervention ( P <0. 05),and the reduction or increase in the observation group was greater than that in the controlled group ( P<0. 05). The clinical total effective rate in the observation group was significantly higher than that in the controlled group ( 95. 45% vs 75. 00%)( P<0. 05). The incidence rate of complications in the observation group was significantly lower than that in the controlled group ( 2. 27% vs 18. 18%)( P<0. 05). The scores of swallowing symptom dimension,swallowing-related dimension and general dimension of SWAL-QOL scale in the two groups were significantly higher than those before treatment ( P<0. 05),and the increase in the observation group was greater than that in the controlled group ( P<0. 05). Conclusions: Electroacupuncture apparatus combined with swallowing speech rehabilitation in the nursing of patients with PBP dysphagia can improve the swallowing function,enhance clinical efficacy,reduce complications,and improve the quality of life of patients.