气道廓清技术联合阶段性综合吞咽训练方案对卒中后吞咽障碍患者吞咽功能及营养状况的影响  

Effect of Airway Clearance Therapy Combined with Stepwise Comprehensive Swallowing Training Program on Swallowing Function and Nutritional Status of Patients with Post-Stroke Dysphagia

作　　者：魏海棠[1] 杨丹[1] 杨珺[1] 杨露[1] 陈燕[1] 盛扬 夏道进 刘志霞[1] WEI Haitang;YANG Dan;YANG Jun;YANG Lu;CHEN Yan;SHENG Yang;XIA Daojin;LIU Zhixia(Department of Rehabilitation Medicine,Wuhan Hankou Hospital/Wuhan Rehabilitation Hospital,Wuhan 430000,China)

机构地区：[1]湖北省武汉市汉口医院、武汉市康复医院康复医学科,430000

出　　处：《实用心脑肺血管病杂志》2025年第4期81-85,91,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：武汉市医学科学研究项目健康发展面上项目(WX23B26)。

摘　　要：目的 探讨气道廓清技术联合阶段性综合吞咽训练方案对卒中后吞咽障碍患者吞咽功能及营养状况的影响。方法 选取2023年5月—2024年5月武汉市汉口医院收治的120例卒中后吞咽障碍患者为研究对象,根据干预方式不同将患者分为对照组55例和联合组65例。对照组患者接受阶段性综合吞咽训练方案,联合组患者接受气道廓清技术联合阶段性综合吞咽训练方案,两组患者干预时间均为6周。比较两组患者干预前及干预6周后吞咽功能[功能性经口摄食量表(FOIS)评分及吞咽功能改善率]、营养状况[白蛋白(ALB)、三酰甘油(TG)、总胆固醇(TC)]、神经营养因子[脑源性神经营养因子(BDNF)、神经生长因子(NGF)]、生活质量[生活质量综合评定问卷-74(GQOLI-74)评分]及并发症发生情况。结果 干预后,两组FOIS评分分别高于本组干预前,且联合组FOIS评分高于对照组(P<0.05)。联合组吞咽功能改善率高于对照组(P<0.05)。干预后,两组ALB、TG、TC、BDNF、NGF,躯体功能、社会功能、心理功能、物质生活状态维度得分及GQOLI-74总分分别高于本组干预前,且联合组ALB、TG、TC、BDNF、NGF,躯体功能、社会功能、心理功能、物质生活状态维度得分及GQOLI-74总分高于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论 气道廓清技术联合阶段性综合吞咽训练方案可明显改善卒中后吞咽障碍患者的吞咽功能、营养状况,提高神经营养因子及生活质量,且未增加并发症。Objective To analyze the effect of airway clearance therapy combined with stepwise comprehensive swallowing training program on swallowing function and nutritional status of patients with post-stroke dysphagia.Methods A total of 120 patients with post-stroke dysphagia admitted to Wuhan Hankou Hospital from May 2023 to May 2024 were selected as the research subjects,the patients were divided into control group(55 cases)and combination group(65 cases)according to different intervention methods.The patients in the control group received stepwise comprehensive swallowing training program,while the patients in the combination group received airway clearance therapy combined with stepwise comprehensive swallowing training program.The intervention time was 6 weeks for both groups.The swallowing function[Functional Oral Intake Scale(FOIS)score and improvement rate of swallowing function],nutritional status[albumin(ALB),triglycerides(TG),total cholesterol(TC)],neurotrophic factors[brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF)],quality of life[Generic Quality of Life Inventory-74(GQOLI-74)score]before intervention and 6 weeks after intervention,and complications were compared between the two groups.Results After intervention,the FOIS score of both groups was higher than that before intervention,and the FOIS score in combination group was higher than that in control group(P<0.05).The improvement rate of swallowing function in combination group was higher than that in control group(P<0.05).After intervention,the ALB,TG,TC,BDNF,NGF,dimension scores of physical functioning,social function,psychological function,material living status and total score of GQOLI-74 of both groups were higher than those before intervention,and the ALB,TG,TC,BDNF,NGF,dimension scores of physical functioning,social function,psychological function,material living status and total score of GQOLI-74 in combination group were higher than those in control group(P<0.05).There was no statistically significant difference in the total incid

关 键 词：卒中 吞咽障碍 气道廓清技术 阶段性综合吞咽训练方案 吞咽功能 营养状况 

分 类 号：R743[医药卫生—神经病学与精神病学]