揿针结合康复训练、综合护理措施治疗脑卒中后假性球麻痹所致吞咽障碍临床研究

Clinical Study on Press-Needle Combined with Rehabilitation Training and Comprehensive Nursing Measures for Dysphagia Caused by Pseudobulbar Palsy After Stroke

目的:观察揿针结合康复训练、综合护理措施治疗脑卒中后假性球麻痹所致吞咽障碍的临床疗效。方法:将90例肝肾阴虚,风痰阻络证患者随机分为对照组和观察组各45例。2组患者均进行康复训练,予摄食指导、口腔卫生指导和心理护理等综合护理措施。观察组加予揿针治疗。疗程均为8周。治疗前、治疗8周后采用洼田氏饮水试验评价吞咽障碍程度,评定标准吞咽功能评估量表(SSA)评分和吞咽障碍特异性生活质量量表(SWAL-QOL)评分;由患者于治疗完成后评价护理满意度;比较2组的临床疗效。结果:治疗后,观察组临床疗效优于对照组(P<0.05)。2组洼田氏饮水试验、SSA及SWAL-QOL评分均较治疗前下降(P<0.01),观察组3项评分均低于对照组(P<0.01)。观察组护理满意度高于对照组(P<0.05)。结论:应用揿针结合康复训练、综合护理措施治疗脑卒中后假性球麻痹所致吞咽障碍患者,可显著减轻吞咽障碍,促进吞咽功能恢复,提高患者的生活质量、临床疗效和护理满意度。

Objective:To observe the clinical effect of press-needle combined with rehabilitation training and comprehensive nursing measures for dysphagia caused by pseudobulbar palsy after stroke. Methods:A total of 90 cases of patients with liver-kidney yin deficiency and wind-phlegm obstructing the collaterals syndromes were randomly divided into the control group and the observation group,45 cases in each group. Both groups were given rehabilitation training and comprehensive nursing measures including diet guidance,oral hygiene guidance and psychological nursing,and the observation group was additionally treated with press-needle. Both groups were treated for eight weeks. Before treatment and after eight-week treatment, the dysphagia was evaluated by water swallow test, and the scores of Standardized Swallowing Assessment(SSA) and Swallowing Quality-of-Life Questionnaire(SWAL-QOL) were assessed. After treatment,the nursing satisfaction was evaluated and the clinical effect in the two groups was compared. Results:After treatment, the clinical effect in the observation group was better than that in the control group(P<0.05). The scores of water swallow test,SSA and SWAL-QOL in the two groups were decreased when compared with those before treatment(P<0.01),and the above three scores in the observation group were lower than those in the control group(P<0.01). The nursing satisfaction in the observation group was higher than that in the control group(P<0.05). Conclusion:The application of press-needle combined with rehabilitation training and comprehensive nursing measures for dysphagia caused by pseudobulbar palsy after stroke can effectively relieve dysphagia,promote the recovery of swallowing function and improve quality of life,clinical effect and nursing satisfaction.