丁苯肽治疗脑梗死后吞咽障碍35例疗效观察

Efficacy of dl-3-n-butylphthalide in the treatment of dysphagia after cerebral infarction in 35 patients

目的观察丁苯肽治疗脑梗死后吞咽障碍的临床疗效。方法选取湖州市第一人民医院2019年12月至2020年12月收治的急性脑梗死后吞咽障碍患者70例,采用随机数字表法分为常规治疗组、丁苯肽组各35例。常规治疗组予常规治疗并配合吞咽功能训练,丁苯肽组在常规治疗组基础上予丁苯肽氯化钠注射液治疗,两组疗程2周。观察两组临床疗效及治疗前后吞咽功能。结果丁苯肽组总有效率为100.0%(35/35),高于常规治疗组的91.4%(32/35),但差异无统计学意义(χ^(2)=1.39,P=0.238)。治疗前,两组洼田饮水试验、标准吞咽功能评估量表(SSA)评分差异均无统计学意义(P=0.898、0.691);治疗后,丁苯肽组洼田饮水试验、SSA评分分别为(0.68±0.76)分、(21.60±2.50)分,均低于常规治疗组的(1.15±0.77)分、(27.62±3.80)分,差异均有统计学意义(t=2.57、7.82,P=0.012、<0.001)。结论丁苯肽治疗急性脑梗死后吞咽障碍有较好的疗效,可有效促进患者吞咽功能的恢复,值得临床推广应用。

Objective To investigate the therapeutic effect of dl-3-n-butylphthalide on dysphagia after cerebral infarction.Methods Seventy acute cerebral infarction patients with dysphagia who received treatment in The First People's Hospital of Huzhou from December 2019 to December 2020 were included in this study.They were randomly assigned to receive either routine treatment combined with swallowing function training(routine treatment group,n=35)or intravenous dl-3-n-butylphthalide,routine treatment,and swallowing function training in combination(dl-3-n-butylphthalide treatment group,n=35).All patients received 2 weeks of treatment.Clinical efficacy and swallowing function training pre-and post-treatment were compared between the two groups.Results Total response rate was significantly higher in the dl-3-n-butylphthalide treatment group than in the routine treatment group[100.0%(35/35)vs.91.4%(32/35),χ^(2)=1.39,P=0.238].Before treatment,there were no significant differences in the scores of the Water-Swallowing Test and the Standardized Swallowing Assessment between the two groups(P=0.898,0.691).The scores of the Water-Swallowing Test and the Standardized Swallowing Assessment measured after treatment in the dl-3-n-butylphthalide treatment group were(0.68±0.76)points and(21.60±2.50)points,which were significantly lower than those in the routine treatment group[(1.15±0.77)points,(27.62±3.80)points,t=2.57,7.82,P=0.012,<0.001].Conclusion Dl-3-n-butylphthalide treatment is highly effective on dysphagia after acute cerebral infarction.It can effectively promote the recovery of a patient's swallowing function.The treatment method is worthy of clinical application.