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目的观察吞咽功能康复训练对卒中后吞咽障碍的恢复与预防肺炎的效果及对预后的影响。方法对267例脑卒中住院患者进行床旁误吸试验,对误吸试验阳性的135例随机分为对照组与训练组,训练组进行各种吞咽功能训练,观察两组吞咽功能恢复、肺炎发生与死亡情况。结果在治疗后14 d与21 d,训练组床旁误吸试验阳性率分别为31.3%与20.6%,而对照组为47.8%和40.3%,训练组均较对照组低(P<0.05);发病后1个月内训练组肺炎发生率11.8%,对照组为22.4%,差异无统计学意义(χ2=2.69,P>0.05);但结合我们的以往资料进行比较,差异有统计学意义(χ2=4.25,P<0.05)。结论脑卒中后吞咽障碍是肺炎的重要危险因素,吞咽功能康复训练能促进患者恢复,减少肺炎发生,改善预后。
Objective To observe the effect of swallowing functional rehabilitation training on the recovery of post-stroke dysphagia and prevention of pneumonia and its prognosis. Methods Totally 267 hospitalized patients with stroke were randomly divided into control group and training group. The training group was given various swallowing functional training, and the swallowing recovery and pneumonia were observed in the two groups And the death situation. Results The positive rate of bedside aspiration test in training group was 31.3% and 20.6% on the 14th day and the 21st day after treatment, while the control group was 47.8% and 40.3%, respectively. The training group was lower than the control group (P <0.05). The incidence of pneumonia was 11.8% in the training group and 22.4% in the control group within 1 month after onset (χ2 = 2.69, P> 0.05); however, the difference was statistically significant when compared with our previous data χ2 = 4.25, P <0.05). Conclusion Swallowing disorder after stroke is an important risk factor of pneumonia. Swallowing functional rehabilitation training can promote the recovery of patients, reduce the incidence of pneumonia and improve the prognosis.