姿势控制联合呼吸康复锻炼对脑出血后吞咽障碍患者肺部感染的防控效果

Effect of posture control combined with respiratory rehabilitation exercise on prevention and control of pulmonary infection in intracerebral hemorrhage patients with dysphagia

目的探讨姿势控制联合呼吸康复锻炼对脑出血后吞咽障碍患者吞咽障碍的改善情况及肺部感染的防控效果。方法研究对象为2020年1月-2020年12月于北京市大兴区人民医院进行康复治疗的脑出血后吞咽功能障碍患者224例,将其随机分为康复锻炼组与对照组,每组112例。对照组均采用常规治疗方式,康复锻炼组在对照组基础上加入姿势控制与呼吸康复锻炼治疗。对比两组患者训练前与训练30 d后经口摄食能力、误吸情况、肺部感染发病情况以及临床疗效。结果训练前,两组脑出血后吞咽功能障碍患者的吞咽功能分级比较,无统计学差异;训练后两组患者吞咽功能分级改善(P<0.05);与对照组相比,训练后康复锻炼组吞咽功能更佳(P<0.05)。康复锻炼组脑出血后吞咽功能障碍患者的临床治疗痊愈率与有效率分别为75.00%与98.22%,对照组脑出血后吞咽功能障碍患者的临床治疗痊愈率与有效率分别为55.36%与87.50%,康复锻炼组优于对照组(P<0.05)。训练后,康复锻炼组渗透-误吸评分以及肺部感染率低于对照组(P<0.05)。结论将姿势控制联合呼吸康复锻炼应用于脑出血后吞咽障碍患者康复训练中,可以显著改善患者的吞咽障碍问题,降低误吸的发生,预防肺部感染。

OBJECTIVE To observe the effect of posture control combined with respiratory rehabilitation exercise on improvement of dysphagia and prevention of pulmonary infection in intracerebral hemorrhage patients with dysphagia.METHODS A total of 224 intracerebral hemorrhage patients with dysphagia who received rehabilitation treatment in Beijing Daxing District People′s Hospital from Jan 2020 to Dec 2020 were recruited as the study subjects and randomly divided into the rehabilitation exercise group and the control group,with 112 cases in each group.The control group was treated with conventional therapy,while the rehabilitation exercise group was given additional posture control and respiratory rehabilitation exercise therapy on basis of the treatment of the control group.The oral feeding ability,aspiration,incidence of pulmonary infection and clinical curative effect were observed and compared between the two groups of patients before the exercise and after the exercise for 30 days.RESULTS There was no significant difference in the classification of swallowing function between the two groups of patients before the exercise;the swallowing function classification of the two groups of patients was improved after the exercise(P<0.05);the swallowing function of the rehabilitation exercise group was better than that of the control group after the exercise(P<0.05).The cure rate and effective rate of clinical treatment of the intracerebral hemorrhage patients with dysphagia were respectively 75.00%and 98.22%in the rehabilitation exercise group,higher than 55.36%and 87.50%in the control group(P<0.05).The osmotic aspiration score and incidence of pulmonary infection were lower in the rehabilitation exercise group than in the control group after exercise(P<0.05).CONCLUSION The posture control combined with respiratory rehabilitation exercise can significantly improve the dysphagia,reduce the incidence of aspiration and prevention the pulmonary infection in the intracerebral hemorrhage patients with dysphagia.