综合康复训练对脑卒中后吞咽障碍及吸入性肺炎发生率的影响

摘要

Objective To investigate the effects of comprehensive rehabilitation training on deglutition disorders and the incidence rate of inhalation pneumonia after crebral stroke.Methods A total of 147 patients with dysphagia after cerebral stroke were randomly divided into study group(n=74) and control group(n=73).The patients in control group were treated by routine nursing and routine swallowing function training,however,the patients in study group,on the basis of control group, were treated by comprehensive rehabilitation training. The functional oral intake rating scale was used to evaluate the swallowing function,and Barthel index was used to evaluate activity of daily living(ADL).Moreover the therapeutic effects and incidence rate of aspiration pneumonia were observed and compared between the two groups.Results There was a significant difference in FOIS before and after treatment between two groups(P<0.05).The total effective rate was 77.03% (57/74) in study group,which was 54.80% (40/73) in control group, there was a significant difference between two groups (P <0.05).Moreover the incidence rate of aspiration pneumonia in study group and control group was 12.16% (9/74) and 26.03% (19/73),respectively,there was a significant difference between two groups(P<0.05).In addition the ADL scores after treatment were significantly increased in both groups,as compared with those before treatment (P<0.05),moreover, there were significant differences between two groups (P <0. 05). In addition the hyoid bone displacement status after treatment in study group was superior to that in control group (P<0.05).Conclusion The comprehensive rehabilitation training can significantly improve the swallowing function of patients with dysphagia due to cerebral stroke,improve the life quality of patients and decrease the incidence rate of aspiration pneumonia.%目的 评价综合康复训练对脑卒中后吞咽障碍及吸入性肺炎的影响.方法 选取接受治疗的脑卒中后吞咽障碍患者147例,随机分为研究组(n=74)和对照组(n=73),对照组给予常规护理和常规吞咽功能训练,研究组在对照组基础上给予综合康复训练.采用功能性经口摄食量表评价吞咽功能,Barthel指数表评价日常生活能力,比较2组的临床疗效和吸入性肺炎的发生率.结果 2组治疗前后FOIS比较差异有统计学意义(P<0.05),治疗后2组差异有统计学意义(P<0.05).研究组总有效率为77.03%,对照组为54.80%,2组比异有统计学意义(P<0.05).2组吸入性肺炎的发生率分别为12.16%和26.03%,差异有统计学意义(P<0.05).2组治疗后的ADL评分均明显增加,与治疗前比较差异有统计学意义(P<0.05),治疗后2组差异有统计学意义(P<0.05).研究组治疗后舌骨位移情况显著高于对照组,差异有统计学意义(P<0.05).结论 综合康复训练能明显改善脑卒中后吞咽障碍患者的吞咽功能、提高生活质量和降低吸入性肺炎的发生率.