학술논문
体外膈肌起搏联合呼吸训练对脑卒中后吞咽障碍患者吞咽和呼吸功能的影响 / Effects of external diaphragmatic pacing combined with breathing training on swallowing and respiratory functions of patients with dysphagia after stroke
Document Type
Academic Journal
Author
Source
浙江医学 / Zhejiang Medical Journal. 46(2):191-195
Subject
Language
Chinese
ISSN
1006-2785
Abstract
目的 探讨体外膈肌起搏联合呼吸训练对脑卒中后吞咽障碍患者吞咽和呼吸功能以及卒中后相关性肺炎(SAP)的影响.方法 选取2022年3月至2023年2月在嘉兴市第二医院康复医学中心住院的脑卒中后吞咽障碍患者60例为研究对象,采用随机数字表法分为联合治疗组和对照组,每组30例.两组患者均接受常规吞咽训练和呼吸训练,联合治疗组在此基础上接受体外膈肌起搏治疗.分别于治疗前及治疗4周后对两组患者进行吞咽功能评定[标准吞咽功能评定量表(SSA)、功能性经口摄食分级评估(FOIS)]和呼吸功能评定[用力肺活量(FVC)、一秒用力呼气容积(FEV1)、峰值呼气流速(PEF)],并计算两组患者SAP发生率.结果 治疗后两组患者SSA及FOIS评分均优于治疗前,且联合治疗组治疗后SSA及FOIS评分均优于对照组,差异均有统计学意义(均P＜0.05).治疗后,两组患者FVC、FEV1和PEF均优于治疗前,且联合治疗组FVC、FEV1和PEF均优于对照组,差异均有统计学意义(均P＜0.05).两组患者SAP发生率分别为6.7％和20.0％,两组比较差异无统计学意义(P=0.255).结论 体外膈肌起搏联合呼吸训练能有效改善脑卒中后吞咽障碍患者的吞咽功能和呼吸功能,但防止SAP的发生效果并不明显.
Objective To observe the effects of external diaphragmatic pacing combined with breathing training on swallowing and respiratory function and stroke-associated pneumonia(SAP)in patients with dysphagia after stroke.Methods Sixty patients with dysphagia after stroke hospitalized in Rehabilitation Medical Center of Jiaxing Second Hospital from March 2022 to February 2023 were selected and divided into treatment group(external diaphragm pacing+breathing and swallowing training)and control group(breathing and swallowing training)by random number table method,with 30 cases in each group.Patients in the two groups were evaluated for swallowing function[using standardized swallowing assessment(SSA)and functional oral intake scale(FOIS)]and respiratory function[using forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and peak expiratory flow(PEF)]before and 4 weeks after treatment.The incidence of SAP in the two groups was also analyzed.Results After treatment,SSA and FOIS scores of the two groups were both significantly improved,with those in the treatment group significantly better than the control group(all P＜0.05).The FVC,FEV1and PEF of the two groups after treatment were statistically better when comapred with those before treatment,with those in the treatment group significantly better than the control group(all P＜0.05).The incidence of SAP in the two groups was 6.7％and 20.0％,respectively,which showed no statistical difference between them(P=0.255).Conclusion External diaphragmatic pacing therapy combined with breathing training can effectively improve the swallowing and respiratory functions of patients with dysphagia after stroke.However,the effect is not significant in reducing the incidence of SAP.
Objective To observe the effects of external diaphragmatic pacing combined with breathing training on swallowing and respiratory function and stroke-associated pneumonia(SAP)in patients with dysphagia after stroke.Methods Sixty patients with dysphagia after stroke hospitalized in Rehabilitation Medical Center of Jiaxing Second Hospital from March 2022 to February 2023 were selected and divided into treatment group(external diaphragm pacing+breathing and swallowing training)and control group(breathing and swallowing training)by random number table method,with 30 cases in each group.Patients in the two groups were evaluated for swallowing function[using standardized swallowing assessment(SSA)and functional oral intake scale(FOIS)]and respiratory function[using forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and peak expiratory flow(PEF)]before and 4 weeks after treatment.The incidence of SAP in the two groups was also analyzed.Results After treatment,SSA and FOIS scores of the two groups were both significantly improved,with those in the treatment group significantly better than the control group(all P＜0.05).The FVC,FEV1and PEF of the two groups after treatment were statistically better when comapred with those before treatment,with those in the treatment group significantly better than the control group(all P＜0.05).The incidence of SAP in the two groups was 6.7％and 20.0％,respectively,which showed no statistical difference between them(P=0.255).Conclusion External diaphragmatic pacing therapy combined with breathing training can effectively improve the swallowing and respiratory functions of patients with dysphagia after stroke.However,the effect is not significant in reducing the incidence of SAP.