间歇管饲联合穴位按摩对脑卒中吞咽障碍患者康复效果的影响

Effect of intermittent tube feeding combined with acupoint massage on rehabilitation effect of cerebral stroke patients with dysphagia

目的探讨间歇管饲联合穴位按摩对脑卒中吞咽障碍患者康复效果的影响。方法选取120例接受康复治疗的脑卒中吞咽障碍患者作为研究对象,采用随机数字表法将其分为A组、B组、C组、D组,各30例。A组采用长期留置胃管干预,B组采用间歇管饲干预,C组采用长期留置胃管联合穴位按摩干预,D组采用间歇管饲联合穴位按摩干预。比较4组患者干预前、干预4周后的标准吞咽功能评估(SSA)量表评分、吞咽生活质量问卷(SWAL-QOL)评分,以及干预期间吸入性肺炎的发生情况。结果干预4周后,4组患者的SSA量表评分均较干预前降低,且B组、C组、D组的SSA量表评分均低于A组,D组的SSA量表评分低于B组及C组(均P<0.05),但B组与C组的SSA量表评分差异无统计学意义(P>0.05)。干预4周后,4组患者的SWAL-QOL评分均较干预前升高,且4组患者的SWAL-QOL评分为D组>B组>C组>A组(均P<0.05)。干预期间,D组吸入性肺炎发生率均低于A组、B组、C组(均P<0.05)。结论间歇管饲联合穴位按摩应用于脑卒中吞咽障碍患者的康复治疗中,可有效促进患者的吞咽功能恢复,提高其生活质量,降低吸入性肺炎发生率,值得临床应用推广。

Objective To explore the effect of intermittent tube feeding combined with acupoint massage on rehabilitation effect of cerebral stroke patients with dysphagia.Methods A total of 120 cerebral stroke patients with dysphagia who received rehabilitation therapy were selected as the research subjects.According to the random number table method,patients were divided into group A,group B,group C,or group D,with 30 cases in each group.Group A employed long-term indwelling gastric catheter for intervention,group B received intermittent tube feeding for intervention,group C was intervened with long-term indwelling gastric catheter combined with acupoint massage,and group D received intermittent tube feeding combined with acupoint massage for intervention.The pre-and 4-week post-intervention scores of the Standardized Swallowing Assessment(SSA)scale,Swallowing Quality of Life Questionnaire(SWAL-QOL),and the occurrence of aspiration pneumonia of patients during intervention were compared between the four groups.Results After 4 weeks of intervention,the SSA scale score in the four groups was decreased as compared with before intervention,and the SSA scale score in groups B,C,and D was lower than that in group A,while the SSA scale score in group D was lower than that in groups B and C(all P<0.05);nevertheless,the SSA scale score had no statistically significant difference between group B and group C(P>0.05).After 4 weeks of intervention,the SWAL-QOL score in patients of the four groups was elevated as compared with before intervention,and the SWAL-QOL score in patients of the four groups interpreted as a descending order as follows:group D>group B>group C>group A(all P<0.05).The incidence rate of aspiration pneumonia in group D was lower than that in groups A,B and C during intervention(all P<0.05).Conclusion Intermittent tube feeding combined with acupoint massage in the application to cerebral stroke patients with dysphagia can effectively promote the recovery of swallowing function,improve their quality of life,and decrease the incidence rate of aspiration pneumonia,and it is worthy of application and promotion.