早期干预对急性脑梗死后吞咽障碍患者营养状况及ADL的影响  

Effects of early intervention on status of nutrition and activities of daily life in patients with dysphagia following acute cerebral infarction

作　　者：黄治飞[1] 朱幼玲[1] 蔡伟[1] 朱双根[1] 穆燕芳[1] 

机构地区：[1]合肥市第一人民医院,合肥230061

出　　处：《山东医药》2010年第24期29-32,共4页Shandong Medical Journal

基　　金：合肥市科技局重点项目(2007-15)

摘　　要：目的探讨早期不同干预措施对急性脑梗死所致吞咽障碍患者的吞咽能力、营养状况及日常生活活动能力(ADL)的影响。方法将100例急性脑梗死后吞咽障碍患者随机分为综合治疗组(康复训练联合针灸治疗)、康复训练组、针灸治疗组及常规药物组各25例,于治疗前、治疗2周后分别采用吞咽电视检查(VFSS)评价吞咽障碍程度,检测血清白蛋白、血红蛋白、总淋巴细胞计数,采用Barthel指数分级法评价ADL。结果治疗2周后,综合治疗组吞咽能力改善有效率优于其他3组(P<0.05);4组血清白蛋白、血红蛋白、总淋巴细胞计数均较治疗前下降(P<0.05),但综合治疗组优于其他3组(P<0.05);2周后综合治疗组Barthel指数分级改善均优于其他3组(P<0.05)。结论急性脑梗死后吞咽障碍经早期康复训练联合针灸治疗,能明显改善吞咽功能,缓解营养不良恶化,促进患者ADL的恢复。Objective To study the effects of early different interventions on swallowing function,status of nutrition and activities of daily life in patients with dysphagia following acute cerebral infarction.Methods One hundred acute cerebral infarction patients with dysphagia were randomly divided into comprehensive treatment group（received rehabilitation training,acupuncture and routine therapy of drug）,routine drug group（routine therapy of drug）,rehabilitation group（received comprehensive rehabilitation training and routine therapy of drug） and acupuncture group（received acupuncture therapy and routine therapy of drug）.Dysphagia and nutritional status were assessed by videofluoroscopic swallowing study（VFSS）.Albumin（Alb）,hemoglobin（Hb）,total lymphocyte count（TLC） and activities of daily life were assessed by Barthel index before treatment and at the 14 th day after treatment.Results After treatment,the effective rate of the comprehensive treatment group was significantly higher than those in other three groups（P0.05）.The Alb,Hb and TLC in the comprehensive treatment group were higher than those in other groups（P0.05）.Barthel index after treatment was significantly higher in the comprehensive treatment group than that in other groups（P0.05）.Conclusions Early rehabilitation training plus acupuncture may improve the swallowing function of acute stroke patients,alleviate the deteriorating malnutrition and enhance their activities of daily life.

关 键 词：脑梗死 吞咽障碍 康复 针灸 日常生活活动能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]