摘要
目的研究黄原胶类增稠剂对老年脑卒中后吞咽功能障碍的临床疗效。方法前瞻性选择2018年1月~2020年1月山东第一医科大学第一附属医院收治的240例老年脑卒中患者,使用随机数表法分为观察组(120例)和对照组(120例)。对照组进行常规康复治疗(包括吞咽器官的康复训练和神经肌肉电刺激治疗)并在食物中添加凝固粉,观察组进行同样的常规康复治疗并在食物中添加黄原胶类增稠剂。观察并记录两组临床疗效、治疗前后吞咽造影(VFSS)评分、治疗前后营养指标水平、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分和治疗后不良反应发生情况。结果治疗后,观察组(86.67%)总有效率明显高于对照组(74.17%),差异有统计学意义(P<0.05);治疗后,两组吞咽期、咽喉期、误吸程度评分均显著高于治疗前,且观察组显著好于对照组,差异均有统计学意义(P<0.05);治疗后,两组体重、白蛋白水平、肱三头肌皮褶厚度均显著高于治疗前,且观察组显著高于对照组,差异均有统计学意义(P<0.05);治疗后1个月开始,两组NIHSS评分均呈现显著下降趋势,且观察组下降幅度显著高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组误吸、刺激性呛咳、发音异常等不良反应率均少于对照组,差异有统计学意义(P<0.05)。结论黄原胶类增稠剂治疗老年脑卒中后吞咽功能障碍患者,能显著改善患者吞咽功能和营养状况,有利于患者神经功能恢复,临床效果好并且安全性高。
Objective To study the clinical effect of xanthan gum thickener on dysphagia after stroke in the elderly.Methods 240 elderly patients with stroke admitted to our hospital from January 2018 to January 2020 were selected as the research objects.All patients were randomly divided into observation group(120 cases)and control group(120 cases).The control group received routine rehabilitation treatment(including rehabilitation training of swallowing organs and neuromuscular electrical stimulation therapy)and added coagulant powder in food,while the observation group received the same routine rehabilitation treatment and added xanthan gum thickener in food.The clinical efficacy,swallowing angiography(VFSS)score before and after treatment,nutritional index level before and after treatment,NIHSS score before and after treatment and the incidence of adverse reactions were observed and recorded.Results After treatment,the total effective rate of the observation group(86.67%)was significantly higher than that of the control group(74.17%),the difference was statistically significant(P<0.05).After treatment,the scores of swallowing stage,throat stage and aspiration degree in the two groups were significantly increased,and the observation group were significantly higher than those in the control group(P<0.05).After treatment,the body weight,albumin level and triceps skinfold thickness of the two groups were significantly increased,and observation group were significantly higher than those of the control group(P<0.05).The NIHSS scores of the two groups were significantly decreased as time went by at 1 month after treatment,and the observation group had significantly better NIHSS scores than those of the control group(P<0.05).After treatment,the adverse reactions such as aspiration,irritating cough and abnormal pronunciation in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Xanthan gum thickener in the treatment of elderly patients with swallowing dysfunction after stroke can sig
作者
孙彦君
张静
乔冉冉
孔亚慧
Sun Yanjun;Zhang Jing;Qiao Ranran(Department of Neurology,The First Affiliated Hospital of Shandong First Medical University,Jinan 250014,China)
出处
《中华保健医学杂志》
2021年第4期362-365,共4页
Chinese Journal of Health Care and Medicine
基金
山东省医药卫生科技发展计划项目(2018WS257)。
关键词
脑卒中
老年患者
吞咽功能障碍
黄原胶类增稠剂
营养状况
Stroke
Elderly patients
Swallowing dysfunction
Xanthan gum thickener
Nutritional status
