吞咽动作观察疗法对脑卒中患者吞咽障碍的影响  

Effect of swallowing action observation therapy on swallowing dysfunction in stroke patients

作　　者：李波 曾明 朱明锦[1] 汪亚群[1] 杨桂芬[1] 孙迪[1] 王魏伟[1] 黄楚楚[1] 叶苏[1] LI Bo;ZENG Ming;ZHU Mingjin;WANG Yaqun;YANG Guifen;SUN Di;WANG Weiwei;HUANG Chuchu;YE Su(Rehabilitation Medical Center,Zhejiang Provincial Tongde Hospital,Hangzhou 310012,China;Rehabilitation Medical Center,Jiaxing Second Hospital in Zhejiang Province,Jiaxing 314000,China)

机构地区：[1]浙江省立同德医院康复医学中心,浙江杭州310012 [2]浙江省嘉兴市第二医院康复医学中心,浙江嘉兴314000

出　　处：《中国现代医生》2019年第27期104-107,111,共5页China Modern Doctor

基　　金：浙江省自然科学基金(LQ19H170001);浙江省“十三五”中医药重点专科建设项目(2017-XK-A27);浙江省嘉兴市科技计划项目(2017AY33036);浙江省医药卫生科技计划项目(2019RC291)

摘　　要：目的探讨吞咽动作观察疗法对脑卒中患者吞咽障碍的影响.方法选取2018年9月~2019年1月于浙江省立同德医院康复医学中心收治的脑卒中伴吞咽障碍患者32例,按随机数字表法分为治疗组(16例)和对照组(16例).两组患者均接受常规吞咽康复治疗,治疗组在常规吞咽康复治疗前辅以吞咽动作观察疗法,即先看吞咽动作视频10 min,然后再开始常规吞咽治疗.对照组则采取常规吞咽康复不辅以吞咽动作观察疗法,而采用看风景及建筑物视频10 min,再开始常规吞咽治疗.两组患者治疗频率均为每周5次,持续8周.分别于治疗前、治疗8周后对两组患者采用进食评估问卷调查(EAT-10)、经口进食能力评估(FOIS)及渗透-误吸评估(PAS)对脑卒中期患者的吞咽功能进行评定.结果治疗前两组患者各项评价指标评定差异无统计学意义(P>0.05);治疗8周后,两组患者上述指标较治疗前均有所改善(P<0.05),且与对照组相比,治疗组的EAT-10评分(18.87±6.07)、FOIS评级(5.20±1.10)、PAS评级(2.43±1.07)的改善较对照组显著(P<0.05).结论吞咽动作观察疗法有助于改善脑卒中吞咽障碍患者的吞咽功能.Objective To investigate the effect of swallowing action observation therapy on swallowing dysfunction in stroke patients. Methods 32 patients with stroke and swallowing dysfunction admitted to the Rehabilitation Medical Center of Zhejiang Provincial Tongde Hospital from September 2018 to January 2019 were randomly divided into treatment group(16 cases) and control group(16 cases). Both groups received routine swallowing rehabilitation. The treatment group was treated with swallowing action observation before routine swallowing rehabilitation, that was, the swallowing action video was first seen for 10 minutes, and then conventional swallowing treatment was started. In the control group, routine swallowing rehabilitation was taken without being supplemented with swallowing action observation therapy, and the scenery and building video were taken for 10 minutes, and then conventional swallowing treatment was started. The frequency of treatment in both groups was 5 times a week for 8 weeks. The swallowing function of patients with mid-stroke was assessed in two groups of patients before and after treatment for 8 weeks using the eating assessment tool(EAT-10), functional oral intake scale (FOIS), and penetration and aspiration scale(PAS). Results There was no significant difference in the evaluation indexes between the two groups before treatment(P>0.05). After 8 weeks of treatment, the above indexes were improved compared with those before treatment(P<0.05). And the EAT-10 score(18.87±6.07), FOIS rating(5.20±1.10), and PAS rating(2.43±1.07) in treatment group were significantly improved than those of the control group(P<0.05). Conclusion Swallowing action observation therapy can improve the swallowing function of patients with dysphagia in stroke.

关 键 词：动作观察疗法 镜像神经元 脑卒中 吞咽功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]