摘要
目的分析个性化呼吸功能训练联合吞咽功能训练对脑卒中伴吞咽障碍患者肺功能、呼吸困难症状、吸入性肺炎(AP)发生率的影响。方法选取宝鸡市中心医院2022年1月至2023年3月收治的脑卒中伴吞咽障碍患者120例进行随机对照研究,采用简单随机化法分为对照组、研究组,各60例。对照组采用常规吞咽功能训练,研究组采用个性化呼吸功能训练联合吞咽功能训练,两组训练8周。比较两组康复效果、反复唾液次数、经口进食质量(FOIS)评分、肺功能[峰值呼气流速(PEF)、用力肺活量(FVC)、第1秒用力呼气量(FEV1)]、呼吸困难症状(mMRC评分)、呼吸肌肌力[最大呼气压百分比(MEP%)、最大吸气压百分比(MIP%)]、生活质量(SWAI-QOL评分)、心理状态(DASS-21评分)、AP发生率、Rosenbek误吸程度。结果研究组总有效率为95.0%(57/60),高于对照组的81.7%(49/60)(χ^(2)=5.18,P=0.023)。训练4周、8周后,研究组反复唾液次数、FOIS评分分别为(3.86±0.25)次、(4.35±0.30)次、(5.29±0.61)分、(5.94±0.50)分,均高于对照组的(3.45±0.28)次、(3.81±0.32)次、(4.73±0.58)分、(5.18±0.54)分(t=8.46、9.54、5.15、8.00,均P<0.05);研究组FVC、FEV1、PEF均高于对照组,mMRC评分均低于对照组(t=4.88、6.05、7.34、7.35、3.82、4.32、4.63、9.23,均P<0.05);研究组MEP%、MIP%均高于对照组(t=3.84、3.82、0.65、3.69,均P<0.05);研究组SWAI-QOL评分分别为(179.26±20.17)分、(189.54±21.06)分,均高于对照组的(162.75±18.43)分、(170.61±20.35)分,DASS-21评分分别为(28.03±2.74)分、(25.71±2.68)分,均低于对照组的(30.15±2.96)分、(28.20±3.17)分(t=4.68、5.01、4.07、4.65,均P<0.05)。训练期间,研究组AP发生率为3.3%(2/60),低于对照组的15.0%(9/60)(χ^(2)=4.90,P=0.027)。训练8周后,研究组Rosenbek误吸程度低于对照组(Z=2.54,P=0.011)。结论个性化呼吸功能训练联合吞咽功能训练能提高脑卒中伴吞咽障碍患者肺功能,改善呼吸困难�
Objective To analyze the effect of individualized respiratory function training combined with swallowing function training on lung function,dyspnea symptoms,and incidence of aspiration pneumonia in patients with stroke complicated by dysphagia.Methods A total of 120 patients with stroke complicated by dysphagia who received treatment at Bao Ji People's Hospital from January 2022 to March 2023 were included in this study.These patients were assigned to a control group and a study group,with 60 patients in each group,using simple randomization.The control group received conventional swallowing function training,while the study group underwent individualized respiratory function training combined with swallowing function training.Both groups were treated for 8 weeks.Rehabilitation outcomes,repetitive saliva swallowing times,quality of oral intake(the Functional Oral Intake Scale score),and lung function parameters(peak expiratory flow rate,forced vital capacity,and forced expiratory volume in 1 second,dyspnea symptoms(the Modified Medical Research Council Dyspnea Scale score),respiratory muscle strength(maximum expiratory pressure percentage and maximum inspiratory pressure percentage),quality of life[the Swallowing Quality of Life questionnaire score],psychological status(the Depression,Anxiety and Stress Scale-21 Items score),incidence of aspiration pneumonia,and severity of aspiration(the Rosenbek scale score)were compared between the two groups.Results The total response rate in the study group was 95.0%(57/60),which was significantly higher than that in the control group[81.7%(49/60),χ^(2)=5.18,P=0.023].After 4 and 8 weeks of training,repetitive saliva swallowing times[(3.86±0.25)times,(4.35±0.30)times]and Functional Oral Intake Scale scores[(5.29±0.61)points,(5.94±0.50)points]in the study group were significantly higher compared with the control group[(3.45±0.28)times,(3.81±0.32)times,(4.73±0.58)points,(5.18±0.54)points,t=8.46,9.54,5.15,8.00,all P<0.05].The values for forced vital capacity,forced expi
作者
隋莹
柳瑛
袁媛
刘岚
Sui Ying;Liu Ying;Yuan Yuan;Liu Lan(Department of Rehabilitation Medicine,Baoji Central Hospital,Baoji 721000,Shaanxi Province,China)
出处
《中国基层医药》
CAS
2024年第9期1281-1287,共7页
Chinese Journal of Primary Medicine and Pharmacy
基金
陕西省宝鸡市卫生健康科研计划(2023-004)。
关键词
卒中
吞咽障碍
康复
抗阻训练
呼吸功能试验
呼吸困难
肺炎
吸入性
Stroke
Deglutition disorders
Rehabilitation
Resistance training
Respiratory function tests
Dyspnea
Pneumonia,aspiration
