脑卒中后吞咽障碍综合康复治疗的评价  

Combination of Feeding-swallowing Training and Acupuncture:an Effective Rehabilitation Method for Dysphagia Post Stroke

作　　者：夏文广[1,2] 郑婵娟[2] 朱遂强[1] 唐洲平[1] 王媛[1] 华强[2] 郭珍立[3] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030 [2]湖北省新华医院脑科中心康复医学科,武汉430015 [3]湖北省新华医院脑科中心神经内科,武汉430015

出　　处：《华中科技大学学报（医学版）》2010年第5期614-619,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨综合康复治疗对脑卒中后吞咽障碍患者吞咽功能恢复的影响。方法 120例脑卒中后伴吞咽功能障碍的患者随机分成2组,即对照组:摄食-吞咽障碍的康复训练;实验组:摄食-吞咽障碍的康复训练+针刺治疗。分别于治疗前、治疗后1、2、3、4周时利用标准吞咽功能评估(SSA)进行吞咽功能床旁评估,在治疗前及治疗4周后利用电视透视吞咽功能检查(VFSS)进行吞咽功能仪器评估,同时评价其日常生活活动能力及生存质量。结果治疗前、治疗后1、2、3、4周各时间点实验组与对照组的SSA评分比较,在治疗前及治疗1周时实验组与对照组之间差异无统计学意义,而在治疗后第2、3、4周,实验组明显低于对照组(均P<0.05);实验组与对照组的吞咽功能、日常生活活动能力及生存质量方面在治疗前后进行比较,实验组各方面在治疗后均较对照组改善显著,差异有统计学意义;且吞咽功能改善程度与日常生活活动能力及生存质量改善程度之间具有显著相关性;实验组治疗满意度与对照组比较,差异有统计学意义。结论综合康复治疗有助于吞咽功能、日常生活活动能力及生存质量的恢复。Objective To assess the effects of feeding-swallowing training combined with acupuncture on the swallow function improvement of patients with dysphagia following stroke.Methods One hundred and twenty patients with dysphagia after stroke were randomly divided into experimental group（n=60）and control group（n=60）.The patients in experimental group were subjected to feeding-swallowing training and acupuncture treatment,while those in control group received feeding-swallowing training alone.SSA,VFSS,MBI and SWAL-QOL were used to assess the swallow function and life quality of patients in two groups before and at the week 1,2,3,4 after treatment.Results There was no significant difference in SSA scores between two groups before and one week after treatment.Compared with those before treatment,the VFSS,MBI and SWAL-QOL scores at the fourth week after treatment were significantly increased and the SSA scores were significantly decreased in both groups（P〈0.05）.The VFSS,MBI and SWAL-QOL scores in experimental group were significantly higher and the SSA scores were significantly lower than those in control group.The SSA score was negatively correlated with VFSS,MBI and SWAL-QOL scores and the satisfactory score of patients in experimental group was significantly higher than that in control group.Conclusion Feeding-swallowing training combined with acupuncture was a better rehabilitation treatment for patients with swallowing disorders after stroke than conventional feeding-swallowing training alone.

关 键 词：吞咽障碍 摄食-吞咽训练 针刺 脑卒中 

分 类 号：R571[医药卫生—消化系统]