脑卒中伴吞咽障碍患者不同训练方法的疗效观察

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1、脑卒中伴吞咽障碍患者不同训练方法的疗效观察［摘要］目的探讨脑卒中伴吞咽障碍患者不同训练方法的疗效。方法选取上海市徐汇区中心医院康复科2015年1月〜2016年6月收治的脑卒中伴吞咽障碍鼻饲患者60例，将其随机分为对照组A、治疗组B、治疗组C，各20例。对照组A采用神经肌肉电刺激、舌肌运动训练、下颌运动训练和进食指导；治疗组B在对照组A训练方法上再加Mendelsohn训练法;治疗组C在对照组A训练方法上再加冰拧檬刺激。每天1次，每次30min,连续训练12d为1个疗程。观察三组患者治疗前后摄食-吞咽功能评分的变化情况及临床疗效。结果经过治疗后，治疗组B摄吞咽功能评分为(4.20

2、±1.08)分，治疗组C摄食-吞咽功能评分为(6.20土0.77)分，两组与对照组A［(2.67±0.82)分］比较，差异有高度统计学意义(P［关键词］脑卒中；吞咽障碍；鼻饲；吞咽功能训［中图分类号］R743.3［文献标识码］A［文章编号］1673-7210(2016)10(a)-0044-04ObservationonthecurativeeffectofdifferenttrainingmethodsforstrokepatientswithdysphagiaLIHonglilMIAOShanzhi2AYANGJianlZHANGYinglDINGShanshanlWANG

3、Meijun21.DepartmentofRehabilitationMedicine，ShanghaiXuhuiCentralHospital，Shanghai200031，China；2.ShanghaiXuhuiFederationofDisabledPersons，Shanghai200030，China[Abstract]ObjectiveToexploretheeffectofdifferenttrainingmethodsforstrokepatientswithdysphagia.MethodsSixtystrokepatientswithdysphagiaby

4、nasalfeedingadmittedtoDepartmentofRehabilitationMedicine，ShanghaiXuhuiCentralHospitalfromJanuary2015toJune2016wereselected.AllcaseswererandomlydividedintocontrolgroupA，treatmentgroupBandtreatmentgroupC,with20casesineachgroup.IncontrolgroupA，thepatientsweretreatedwithneuromuscularelectricalst

5、imulation,tonguemusclemotortraining，mandibulartrainingandfeedingdirection；thepatientsintreatmentgroupBweretreatedadditionallywithMendelsohnmethodonbasisofcontrolgroupA；thepatientsintreatmentgroupCweretreatedadditionallywithicelemonstimulationonbasisofcontrolgroupA.Onceaday，30mineachtime，12da

6、yswasasacourse.Thechangesoffeeding-swallowingfunctionscoresbeforeandaftertreatment，andtheclinicalefficacyofthethreegroupswereobserved.ResultsAftertreatment，thefeeding-swallowingfunctionscoreoftreatmentgroupBwas(4.20±1.08)points，andthefeeding-swallowingfunctionscoreoftreatmentgroupCwas(6.20+0

7、.77)points，bothgroupshadhighlystatisticallysignificantdifferencescomparedwiththatofcontrolgroupA[(2.67±0.82)points](P[Keywords]Stroke；Dysphagia；Nasalfeeding；Swallowingfunctiontraining吞咽障碍是脑卒中患者的常见并发症，已有研宄证明，脑卒中后合并吞咽障碍的发生率为30%〜78%[1]。脑卒中后重度吞咽障碍可严重影响