舌压抗阻反馈训练在缺血性脑卒中患者吞咽障碍康复中的效果研究

Effect of tongue pressure resistance feedback training on rehabilitation of swallowing disorders in patients with ischemic stroke

  • 摘要:
    目的  探讨舌压抗阻反馈训练在缺血性脑卒中(IS)患者吞咽障碍康复中的效果。
    方法  将100例IS后吞咽障碍患者随机分为对照组(给予常规康复治疗和口腔运动训练)和实验组(在常规康复治疗基础上给予舌压抗阻反馈训练),每组50例,疗程均为4周。研究期间,有3例患者因自身原因未能完成研究而脱落,最终对照组49例、实验组48例完成研究。治疗前后,测量2组患者舌肌功能; 采用吞咽造影(VFSS)测量吞咽活动时间学参数与运动学参数; 采用Rosenbek渗漏/误吸量表(PAS)评估误吸风险; 采用吞咽障碍特异性生活质量量表(SWAL-QOL)评价生活质量; 比较2组并发症发生情况。
    结果  治疗4周后, 2组舌压峰值、平均值及持续时间均升高,且实验组上述指标均高于对照组; 2组口腔运送时间、软腭上抬时间、舌骨位移时间缩短,食管上括约肌(UES)开放时间和喉关闭时间延长,舌骨与甲状软骨上移、前移、UES开放程度均升高,咽腔收缩率(PCR)降低,且实验组上述各项指标均优于对照组; 2组PAS评分均降低, SWAL-QOL评分均升高,且实验组PAS评分低于对照组,SWAL-QOL评分高于对照组; 上述组间差异均有统计学意义(P < 0.05)。实验组并发症发生率为4.17%(2/48), 对照组为10.20%(5/49), 差异无统计学意义(P>0.05)。
    结论  在IS后吞咽障碍患者的康复治疗中,舌压抗阻反馈训练能够改善患者的舌功能与吞咽功能,有效降低吞咽后误吸风险,提高患者生活质量。

     

    Abstract:
    Objective  To explore the effect of tongue pressure resistance feedback training in the rehabilitation of dysphagia in patients with ischemic stroke (IS).
    Methods  A total of 100 patients with dysphagia after IS were randomly divided into control group (receiving conventional rehabilitation therapy and oral motor training) and experimental group (receiving tongue pressure resistance feedback training on the basis of conventional rehabilitation therapy), with 50 patients in each group. The treatment duration was 4 weeks for both groups. During the study, 3 patients dropped out due to personal reasons, and ultimately 49 patients in the control group and 48 patients in the experimental group completed the study. Before and after treatment, tongue muscle function was measured in both groups; videofluoroscopic swallowing studies (VFSS) were used to measure temporal and kinematic parameters of swallowing; the Rosenbek Penetration-Aspiration Scale (PAS) was used to assess aspiration risk; the Stroke and Aphasia Quality of Life Scale (SWAL-QOL) was used to evaluate quality of life; and occurrence of complications in both groups were compared.
    Results  After 4 weeks of treatment, peak tongue pressure, mean tongue pressure, and tongue pressure duration increased inboth groups, with these indicators being higher in the experimental group than in the control group; oral transit time, soft palate elevation time, and hyoid bone displacement time shortened, while upper esophageal sphincter (UES) opening time and laryngeal closure time prolonged, hyoid and thyroid cartilage movement (upward and anterior displacement) and UES opening degree increased, and pharyngeal contractile ratio (PCR) decreased in both groups, with these indicators being superior in the experimental group compared to the control group; PAS scores decreased and SWAL-QOL scores increased in both groups, with PAS scores being lower and SWAL-QOL scores being higher in the experimental group compared to the control group; the differences between the two groups in the aforementioned indicators were statistically significant (P < 0.05). The complication rate was 4.17% (2/48) in the experimental group and 10.20% (5/49) in the control group, with no statistically significant difference (P>0.05).
    Conclusion  Tongue pressure resistance feedback training can improve tongue function and swallowing function, effectively reduce the risk of aspiration after swallowing, and enhance the quality of life of patients with dysphagia after IS during their rehabilitation treatment.

     

/

返回文章
返回