开窍利咽按摩法联合舌压抗阻反馈训练在卒中后吞咽障碍患者康复护理中的应用

Application of kaiqiao liyan massage combined with tongue pressure resistance feedback training in rehabilitation nursing of patients with dysphagia after stroke

目的观察开窍利咽按摩法联合舌压抗阻反馈训练在卒中后吞咽障碍(DAS)患者康复护理中的应用效果。方法前瞻性选取2019年1月—2020年1月山东省青岛市海慈医疗集团青岛市中医医院收治的100例DAS患者,采用随机数字表法分为对照组和观察组,每组各50例。对照组采用常规康复护理+舌压抗阻反馈训练,观察组采用常规康复护理+舌压抗阻反馈训练+开窍利咽按摩法,均连续干预4周。比较两组干预前及干预4周时的吞咽功能[采用Rosenbek渗透-误吸量表(PAS)评分]、吞咽障碍程度(VGF)评分、生活质量[采用吞咽障碍特异性生活质量量表(SWAL-QOL)评估],统计干预期间并发症发生情况。结果干预4周后,两组PAS评分较干预前降低,VGF评分较治疗前升高,且观察组PAS评分低于对照组,VGF评分高于对照组,差异有统计学意义(P<0.05);两组干预4周后SWAL-QOL评分均较干预前升高,且观察组高于对照组,差异有统计学意义(P<0.05);两组干预期间的并发症总发生率比较,差异无统计学意义(P>0.05)。结论DAS患者在康复护理期间采用开窍利咽按摩法联合舌压抗阻反馈训练,可提高患者康复护理获益,患者生活质量及吞咽功能均明显改善,值得应用。

Objective To observe the application effect of kaiqiao liyan massage combined with tongue pressure resistance feedback training in rehabilitation nursing of patients with dysphagia after stroke(DAS).Methods A total of 100 patients with DAS from January 2019 to January 2020 treated in Qingdao Haici Medical Group Qingdao Traditional Chinese Medicine Hospital were prospectively selected,the random number table method was used to divide them into control group and observation group,with 50 cases in each group.The control group was given routine rehabilitation nursing+tongue pressure resistance feedback training;the observation group was given routine rehabilitation nursing+tongue pressure resistance feedback training+resuscitation and throat massage,both were intervened continuously for four weeks.The swallowing function(evaluated by Rosenbek penetration-aspiration scale[PAS]),degree score of dysphagia(VGF)and quality of life(evaluated by swallowing quality of life questionnaire[SWAL-QOL])were compared between the two groups before and after four weeks of intervention,the incidence of complications during the intervention was statistically analyzed.Results After four weeks of intervention,the PAS score in both groups was decreased than that before intervention,the VGF score was increased than that before treatment,and the PAS score in the observation group was lower than the control group,and the VGF score was higher than the control group,with statistical significant differences(P<0.05);after four weeks of intervention,the SWAL-QOL score of both groups were increased than that before intervention,the observation group was higher than the control group,with statistical significant differences(P<0.05).There were no significant difference in the total incidence of complications between two group(P>0.05).Conclusion Patients with DAS receiving kaiqiao liyan massage combined with tongue pressure resistance feedback training during rehabilitation nursing can improve the benefits of rehabilitation nursing in patients,the swallowing function and quality of life of patients are significantly improved,which is worthy of application.