电生理疗法联合吞咽-摄食训练治疗脑卒中后吞咽障碍疗效观察
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(深圳市龙华区中心医院康复医学科,深圳 518110)

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R742


Therapeutic effect of electrophysiological therapy combined with swallowing-feeding training in dysphagia patients after stroke
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(Department of Rehabilitation Medicine, Central Hospital of Longhua District of Shenzhen City, Shenzhen 518110, China)

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    【摘要】目的 探讨电生理疗法联合吞咽-摄食训练治疗脑卒中后吞咽障碍的临床疗效。方法 入选2016年6月至2017年12月在深圳市龙华区中心医院就诊治疗的脑卒中后吞咽障碍患者135例。依据治疗方法不同,按随机数表法将135例患者分为3组:康复训练组、电生理疗法组和联合治疗组,每组45例。康复训练组行单纯吞咽-摄食康复训练治疗,电生理疗法组行单纯电生理疗法,联合治疗组行电生理疗法联合吞咽-摄食训练进行治疗,均治疗4周。对比分析3组患者的治疗有效率、治疗前后Gugging吞咽功能评估量表(GUSS)评分、功能性经口摄食量表(FOIS)分级,并比较3组并发症发生情况。采用SPSS 19.0软件进行数据处理。依据数据类型,组间比较分别采用t检验或χ2检验。结果 联合治疗组患者的治疗显效率(53.3% vs 33.3% vs 35.6%)、总有效率(95.6% vs 73.3% vs 75.6%)均高于康复训练组和电生理疗法组,差异有统计学意义(P<0.05)。治疗后,联合治疗组的GUSS评分[(14.26±2.59) vs(11.43±2.31) vs(11.98±2.40)]、FOIS评分 [(4.02±1.27) vs(2.91±0.75) vs(3.52±0.74)]显著高于康复训练组及电生理疗法组(P<0.05)。联合治疗组患者并发症总发生率(4.4%)较康复训练组(44.4%)和电生理疗法组(26.7%)显著降低,差异均具有统计学意义(P<0.05)。结论 电生理疗法联合吞咽-摄食训练治疗脑卒中后吞咽障碍疗效显著,可有效提高吞咽功能,减少并发症。

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    【Abstract】Objective To investigate the clinical efficacy of electrophysiological therapy combined with swallowing-feeding training in the treatment of dysphagia after stroke. Methods A total of 135 patients with dysphagia after stroke who admitted to our hospital from June 2016 to December 2017 were recruited as the observation subjects, and were randomly divided into 3 groups, with 45 cases in each group. The patients from the rehabilitation training group were treated with only swallowing-feeding training, those of the electrophysiological therapy group were given electrophysiological therapy, and those of the combined treatment group underwent both the training and the therapy. After 4 weeks′ treatment, the effective rate, score of Gugging swallowing screen (GUSS), and results of functional oral intake scale (FOIS) were compared among the 3 groups, as well as the rate of complications. SPSS statistics 19.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed in inter-group comparison for different data types. Results The combined treatment group obtained significantly higher markedly effective rate (53.3%) and total effective rate (95.6%) when compared with the rehabilitation training group (33.3%, 73.3%) and electrophysiological therapy group (35.6%, 75.6%, all P<0.05). What′s more, the GUSS score [(14.26±2.59) vs(11.43±2.31) vs(11.98±2.40)] and FOIS score [(4.02±1.27) vs(2.91±0.75) vs(3.52±0.74)] were also obviously higher in the combined treatment group than the other 2 groups (all P<0.05). The total incidence of complications in the combined treatment group (4.4%) was also significantly lower than that in the rehabilitation training group (44.4%) and electrophysiological therapy group (26.7%, both P<0.05). Conclusion The combination of electrophysiological therapy and swallowing-feeding training is effective in the treatment of dysphagia after stroke, and can effectively improve the swallowing function and reduce occurrence of complications.

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何小燕,钟建兵,刘剑.电生理疗法联合吞咽-摄食训练治疗脑卒中后吞咽障碍疗效观察[J].中华老年多器官疾病杂志,2019,18(5):360-364

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  • 收稿日期:2018-12-25
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  • 在线发布日期: 2019-05-29
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