吞咽康复训练与文拉法辛对急性脑损伤患者吞咽障碍的影响  

Effects of Venlafaxine and Swallowing Rehabilitation Training on Dysphagia of Acute Brain Injury Patients

作　　者：罗青[1] 龙曼丽[1] 田静 周游[1] 黄娟[1] 聂玉萍[1] 纪玉桂[1] LUO Qing;LONG Manli;TIAN Jing;ZHOU You;HUANG Juan;NIE Yuping;JI Yugui(Department of Neurosurgeons,Cruangzhou General Hospital of Chinese People＇s Liberation Army,Guangzhou Guangdong 510010,China)

机构地区：[1]原广州军区广州总医院神经外科,广东广州510010

出　　处：《华南国防医学杂志》2018年第9期612-615,共4页Military Medical Journal of South China

摘　　要：目的探讨文拉法辛结合吞咽康复训练对急性脑损伤患者吞咽障碍的影响。方法选择符合入选条件伴有吞咽障碍的脑损伤患者87例,按照随机原则分为对照组、文拉法辛组和文拉法辛康复组。采用饮水评估方法和标准吞咽功能评定量表(standardized swallowing assessment,SSA)评估各组患者治疗后7d和21d的吞咽状况。结果治疗前,3组患者一般资料比较无统计学差异(P>0.05)。与对照组比较,治疗后7d,文拉法辛康复组吞咽功能恢复正常人数较对照组明显增多(P<0.05);治疗后21d,文拉法辛组、文拉法辛康复组吞咽功能恢复正常人数较对照组明显增多(P均<0.05)。治疗前,3组SSA评分比较无统计学差异(P>0.05),治疗后7d和21d,文拉法辛组、文拉法辛康复组SSA评分均较对照组明显降低(P均<0.05)。在观察期间内,文拉法辛组、文拉法辛康复组患者肺部感染发生率较对照组均无统计学差异(P>0.05)。结论急性脑损伤患者使用文拉法辛可以明显促进患者吞咽功能障碍的恢复,同时配合吞咽基础训练可增加文拉法辛的促康复作用。Objective To observe the effect of venlafaxine and swallowing rehabilitation training on dysphagia of acute brain injury patients.Methods Eighty-seven brain injury patients with dysphagia who met the inclusion criteria were selected and divided into control group,venlafaxine group and venlafaxine rehabilitation group according to the randomized principle.The dysphagia condition of patients were evaluated by water drinking test and standardized swallowing assessment（SAA）at 7 and 21 days after treatment.Results There were no significant difference in general conditions of patients among three groups before treatment（P〉0.05）.The number of patients who recovered to normal or almost normal function of deglutition in venlafaxine group was significantly more than that in control group at 7 days after treatment（P〈0.05）.The number of patients who recovered to normal or almost normal function of deglutition in venlafaxine group and venlafaxine rehabilitation group increased significantly compared with control group at 21 days after treatment（all P〈0.05）.Before treatment,there had no significant difference in SSA scores among three groups（P〉0.05）.The scores of SSA in venlafaxine group and venlafaxine rehabilitation group were significantly decreased than those in control group both at 7 days and 21 days after treatment（all P〈0.05）.The incidence of pneumonia in venlafaxine group and venlafaxine rehabilitation group was not significantly different than that in control group during the observation.Conclusion In acute brain injury patients,the early usage of venlafaxine,meanwhile,cooperating with the swallowing rehabilitation training,can significantly facilitate the recovery of dysphagia.

关 键 词：文拉法辛 基础吞咽训练 脑损伤 吞咽障碍 

分 类 号：R651.15[医药卫生—外科学]