改良K点刺激结合长棉枝及陈皮水口腔护理对脑卒中吞咽困难的干预效果研究  

Effect of improved K-point stimulation combined with long cotton swabs and preserved tangerine peel water on oral care for patients with dysphagia after cerebral apoplexy

作　　者：周远远[1] 田杏音[1] ZHOU Yuanyuan;TIAN Xingyin(Guangzhou First People’s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院,广东广州510180

出　　处：《现代医院》2022年第11期1798-1800,1804,共4页Modern Hospitals

基　　金：广东省基础与应用基础研究基金(2019A1515011273);广州市第一人民医院红棉计划项目(H2019014)。

摘　　要：目的探讨改良K点刺激结合长棉枝及陈皮水口腔护理在脑卒中吞咽困难患者中的效果。方法用随机数字法将120例张口困难的脑卒中患者分为观察组60例和对照组60例。观察组应用K点刺激患者开口结合长棉枝擦拭口腔,且擦拭溶液采用陈皮水。对照组实施常规生理盐水口腔护理。每天擦拭2次,早晚各1次,干预1 w后,比较两组吞咽反射、张口度、痰液量及肺部感染发生率。结果干预1 w后,观察组吞咽反射优于对照组(P<0.05),观察组张口度得分高于对照组(P<0.05),观察组痰液量小于对照组(P<0.05),两组肺部感染发生率差异无明显统计学意义(P>0.05)。结论使用改良K点刺激结合长棉枝及陈皮水进行口腔护理能有效改善卒中患者吞咽功能和张口困难症状,减少卒中患者痰液量,但由于干预时间受限,未能有效降低脑卒中患者肺部感染发生率。Objective To explore the effect of modified K-point stimulation combined with long cotton branches and tangerine peel water on oral care for patients with dysphagia after stroke.Methods One hundred and twenty stroke patients with difficulty in opening their mouths were evenly divided into experimental group and control group with a random number table.In the experimental group,The method of K point was used to stimulate the patients to open their mouths,followed by wiping the mouth with long cotton swabs dipped with preserved tangerine peel water,twice every day,one in the morning and the other in the afternoon.The control group received routine oral care with normal saline twice every day,one in the morning and the other in the afternoon.After one-week intervention,the swallowing reflex,mouth opening,sputum volume and lung infection incidence were compared between the two groups.Results The swallowing reflex in the experimental group was improved significantly better than in the control group(P<0.05).One week after intervention,The score of mouth opening in the experimental group was significantly higher than that of control group(P<0.05).The amount of sputum in the experimental group was significantly smaller than that in control group(P<0.05).There was no significant difference in the incidence of pulmonary infection between the two groups(P>0.05).Conclusion Oral care using modified K-spot stimulation combined with long cotton branches dipped with preserved tangerine peel water can effectively stimulate the stroke patients with dysphagia to open mouths,thereby improving their swallowing function and reducing sputum volume in them,but it may not be effective in reducing the incidence of pulmonary infection in case of limited intervention time.

关 键 词：K点刺激 陈皮水 口腔护理 脑卒中 吞咽困难 

分 类 号：R743.09[医药卫生—神经病学与精神病学] R473.74[医药卫生—临床医学]