不同吞咽训练方式对桥小脑角区肿瘤术后吞咽障碍病人护理效果的影响

Effects of different swallowing training methods on postoperative dysphagia of patients with tumors in cerebellopontine angle region

[目的]探讨不同吞咽训练方式对桥小脑角区肿瘤术后吞咽障碍病人护理效果的影响。[方法]选取2017年1月—2018年12月在我院神经外科手术的桥小脑角区肿瘤术后吞咽障碍病人60例,按随机数字表法分为3组各20例,A组采用运动想象训练联合常规吞咽训练,B组采用任务导向训练联合常规吞咽训练,C组采用常规吞咽训练,干预时间均为4周。干预前后应用洼田饮水试验、X线吞咽造影检查(VFSS)评估干预效果,比较3组并发症发生率。[结果]干预后3组病人洼田饮水试验分级比较差异有统计学意义(P<0.001);A组总显效率为85%、B组总显效率为95%,C组总显效率为70%,3组比较差异有统计学意义(P<0.05);A组VFSS评分为(6.37±1.31)分,B组VFSS评分为(8.89±1.42)分,C组VFSS评分为(5.34±1.07)分,3组比较差异有统计学意义(P<0.001);A组并发症发生率为20%,B组并发症发生率为5%,C组并发症发生率为20%,3组比较差异有统计学意义(P<0.01)。[结论]任务导向训练联合常规吞咽训练能明显改善桥小脑角区肿瘤术后吞咽障碍病人的吞咽功能且能降低并发症的发生率。

Objective:To probe into nursing effects of different swallowing training methods on postoperative dysphagia of patients with tumors in cerebellopontine angle region.Methods:A total of 60 patients with dysphagia after cerebellopontine angle surgery in neurosurgery in our hospital were selected from January 2017 to December 2018.Using random number table method,they were divided into three groups:group A(motor imagery training combined with routine swallowing training),group B(task-oriented training combined with routine swallowing training),and control group C(routine swallowing training),each with 20 cases.The intervention lasted for 4 weeks.Before and after intervention,intervention effects were evaluated by Watian drinking test and video fluoroscopy swallowing test(VFSS).And incidence of complications was compared among the three groups.Results:After intervention,there were statistically significant differences in the grades of Watian drinking test among the three groups(P<0.001).The obvious efficiency of group A was 85%,that of group B was 95%,and that of group C was 70%,differences among the three groups were statistically significant(P<0.05).VFSS score of group A was 6.37±1.31,that of group B was 8.89±1.42,and that of group C was 5.34±1.07.There were statistical differences among three groups(P<0.001).Incidence of complications in group A was 20%,that in group B was 5%,and that in group C was 20%,with statistically significant differences among the three groups(P<0.01).Conclusion:Task-oriented training combined with routine swallowing training can significantly improve the swallowing function and reduce the incidence of complications in patients with dysphagia after cerebellopontine angle tumor surgery.