间歇管饲联合穴位按摩对脑卒中后吞咽障碍患者吞咽功能及生活质量的影响

Effects of intermittent tube feeding combined with acupoint massage on swallowing function and quality of life in patients with dysphagia after stroke

目的:探讨间歇性经口至食管管饲法(IOE)联合穴位按摩对脑卒中吞咽障碍患者吞咽功能及生活质量的影响。方法:选取112例脑卒中吞咽障碍患者作为研究对象,按随机数字表法分为A~D共4组各28例,A组给予长期留置胃管管饲,B组给予IOE,C组给予长期留置胃管管饲联合穴位按摩,D组采用IOE联合穴位按摩。干预前及干预4周后分别观察4组患者的吞咽功能、营养状况及生活质量情况。结果:干预4周后,4组患者SSA评分较干预前均明显降低(P<0.05),且D组SSA评分低于A、B、C组(P<0.05);B、C组SSA评分均低于A组(P<0.05),B组与C组比较差异无统计学意义;干预后,4组患者白蛋白、血红蛋白水平及SWAL-QOL评分较干预前均明显提高(均P<0.05),且D组均高于A、B、C组(均P<0.05);B组高于A、C组(P<0.05);A组与C组比较差异均无统计学意义。干预期间,B、D组未发生吸入性肺炎,A、C组吸入性肺炎发生率分别为4例(14.29%)、2例(7.14%),B、D组吸入性肺炎发生率均明显低于A、C组(P<0.05)。A组与C组吸入性肺炎发生率比较差异无统计学意义。结论:IOE联合穴位按摩能有效促进脑卒中患者吞咽功能恢复,保障营养供给,提高其生活质量。

Objective:To explore the effect of intermittent tube feeding(IOE)combined with acupoint massage on swallowing function and quality of life in patients with dysphagia after stroke.Methods:A total of 112 stroke patients with swallowing disorders were selected as the research subjects and randomly divided into 4 groups,A to D,with 28 cases in each group.Group A received long-term indwelling gastric tube feeding,group B received IOE,group C received long-term indwelling gastric tube feeding combined with acupoint massage,and group D received IOE combined with acupoint massage.The swallowing function,nutritional status,and quality of life of patients in the four groups were observed before and after the intervention for 4 weeks.Results:After 4 weeks of intervention,the SSA score,SWAL-QOL score,albumin value and hemoglobin value in the four groups were significantly improved(P<0.05).The SSA score in group D was lower than that in groups A,B and C(P<0.05).The SSA scores in groups B and C were lower than those in group A(P<0.05).The albumin level,hemoglobin level and SWAL-QOL score in the group D were higher than those in groups A,B and C(P<0.05).The levels of albumin and hemoglobin in the group B were higher than those in groups A and C(P<0.05).SWAL-QOL scores in groups B and C were higher than those in the group A(P<0.05).During the intervention period,there was no inhalation pneumonia in groups B and D,and the incidence of inhalation pneumonia in groups A and C was 14.29%(4/28)and 7.14%(2/28),respectively,and there was significant difference in the incidence of inhalation pneumonia among the 4 groups(χ2=7.918,P<0.05).Conclusion:Intermittent tube feeding combined with acupoint massage can promote the recovery of swallowing function in stroke patients,ensure nutritional supply and improve their quality of life.