床旁吞咽治疗对ICU的脑卒中伴意识障碍患者吞咽功能及意识状态的疗效观察  

Effects of bedside swallowing therapy on swallowing function and conscious state of stroke patients with disturbance of consciousness in ICU

作　　者：胡乃晓 王贞[1] 虎盘林 翟蕾[2] 董剑虹[2] 张庆苏[1] HU Naixiao;WANG Zhen;HU Panlin(China Rehabilitation Research Center,Beijing,100068)

机构地区：[1]中国康复研究中心北京博爱医院听力语言科,北京市100068 [2]中国康复研究中心北京博爱医院重症医学科

出　　处：《中国康复医学杂志》2024年第12期1823-1828,共6页Chinese Journal of Rehabilitation Medicine

基　　金：中国康复研究中心青年基金课题(2021zx-Q3)。

摘　　要：目的:探讨床旁吞咽治疗对在ICU的脑卒中伴意识障碍患者吞咽功能及意识状态的疗效。方法:2021年6月—2023年9月,ICU的脑卒中伴意识障碍患者60例随机分成对照组(n=30)和观察组(n=30),对照组采用ICU临床治疗,观察组在ICU临床治疗基础上增加床旁吞咽治疗,共治疗4周。治疗前后对患者吞咽功能及意识状态进行评定。结果:治疗后,观察组2min自发吞咽频率(1.17±0.99)次,高于对照组(0.67±0.84)次,差异有显著性意义(P<0.05);治疗后,观察组简易吞咽激发测试第一步和第二步阳性率分别为66.7%和43.3%,均低于对照组80%和56.7%,且观察组简易吞咽激发测试第二步阳性率治疗后显著低于治疗前,差异有显著性意义(P<0.05);治疗后,观察组标准吞咽功能评价量表评分显著低于对照组评分,差异有显著性意义(P<0.05)。治疗后,观察组格拉斯哥昏迷量表评分显著高于对照组评分,差异有显著性意义(P<0.05)。结论:床旁吞咽治疗对在ICU的脑卒中伴意识障碍患者吞咽功能及意识状态均具有改善作用。Objective:To investigate the effect of bedside swallowing therapy on swallowing function and conscious status of stroke patients with disturbance of consciousness in ICU.Method:From June 2021 to September 2023,60 patients with stroke and disturbance of consciousness in ICU were randomly divided into control group(n=30)and observation group(n=30).The control group received clinical treatment in ICU,and the observation group was treated with bedside swallowing therapy on the basis of clinical treatment in ICU for a total of 4 weeks.Swallowing function and state of consciousness were evaluated before and after treatment.Result:After treatment,the 2-minute frequency of spontaneous swallowing in the observation group was(1.17±0.99)times,which was higher than that in the control group(0.67±0.84)times,and the difference was statistically significant(P<0.05).After treatment,the positive rate of the first and second steps of simple swallowing provocation test in the observation group was 66.7% and 43.3%,respectively,both lower than that of the control group 80% and 56.7%,and the positive rate of the second step of simple swallowing provocation test in the observation group was significantly lower after treatment than before treatment,with statistical significance(P<0.05).After treatment,standardized swallowing assessment score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the score of glasgow coma scale in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Bedside swallowing therapy can improve the swallowing function and conscious state of stroke patients with disturbance of consciousness in ICU.

关 键 词：ICU 脑卒中 意识障碍 床旁吞咽治疗 2min自发吞咽频率 简易吞咽激发测试 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]