早期VitalStim治疗仪联合吞咽康复训练对脑梗死后吞咽障碍康复预后的影响

Efficacy of early VitalStim therapeutic apparatus combined with swallowing rehabilitation training on rehabilitation prognosis of post-stroke dysphagia

目的:探究早期VitalStim治疗仪联合吞咽康复训练对脑梗死后吞咽障碍康复预后的影响。方法:选取脑梗死合并吞咽障碍患者96例,随机分为3组,3组均给予脑梗死常规用药治疗,A组采用VitalStim治疗仪给予治疗,B组给予吞咽康复训练的方式给予治疗,C组采用VitalStim治疗仪联合吞咽康复训练的方式给予治疗,对比3组患者吞咽功能、生活质量改善情况以及相关性肺炎(SAP)发生率及营养检测指标的改善情况。结果:治疗后,3组吞咽功能评价量表(SSA)评分均较治疗前下降(P<0.05),且C组更低于其他2组(P<0.05);治疗后3组生活质量评分均较治疗前提高(P<0.05),C组饮食控制、按时服药、社会功能及心理健康评分更高于A组及B组(P<0.05);治疗后3组维生素A、维生素E、铁、锌、热量及膳食纤维含量虽然比治疗前有所提升,但差异无统计学意义,3组蛋白质、膳食纤维、维生素C及钙水平较治疗前明显提高(P<0.05),且C组蛋白质、维生素C及钙水平更高于其他2组(P<0.05);治疗期间及出院后半年内SAP的发生率比较,C组明显低于其他2组(P<0.05)。结论:通过对脑梗死患者进行早期VitalStim治疗仪联合吞咽康复训练,可以促进患者吞咽功能的恢复,促进患者对营养的摄取,有效改善患者的生活质量并降低SAP发生率。

Objective:To explore the efficacy of early VitalStim therapeutic apparatus combined with swallowing rehabilitation training on the rehabilitation prognosis of post-stroke dysphagia.Methods:Ninety-six patients with post-stroke dysphagia treated in our hospital were randomly divided into three groups.All three groups were treated with conventional cerebral infarction.Group A was treated with an early VitalStim therapy device,group B was given a treatment for swallowing rehabilitation training,and group C was treated with an early VitalStim therapy device combined with swallowing rehabilitation training.The swallow function,and quality of life improvement,the incidence of associated pneumonia(SAP)and improvement in nutritional testing indicators were compared among the three groups.Results:After treatment,the standardized swallowing assessment(SSA)scores decreased in all three groups,and those in the group C were significantly lower than the rest two groups(P<0.05).The scores of quality of life in the three groups were significantly improved.The scores for the dietary control,on-time medication,social function and mental health in the group C were significantly higher than those in the group A and group B(all P<0.05).Although vitamin A,vitamin E,iron,zinc,calories and fiber content in the diet were slightly increased in three groups after treatment,there was no statistically significant difference among the three groups before and after treatment.The protein,dietary fiber and vitamin C and calcium levels in three groups after treatment were significantly increased as compared with those before treatment(P<0.05),and the protein,vitamine C and calcium levels in group C were significantly higher than those in the resting two groups(P<0.05).The incidence of SAP in group C during the treatment period and within half a year after discharge was significantly lower than that in the rest two groups(P<0.05).Conclusion:The early VitalStim therapy device combined with swallowing rehailitation training for stroke patients can promote the recovery of swallowing function,promote the nutrition intake of patients,effectively improve the quality of life of patients and reduce the incidence of SAP.