曹芳真,刘敏,张春华,等.球囊导管扩张联合吞咽基础训练对脑桥出血后气管切开患者吞咽功能的影响[J].中华物理医学与康复杂志,2024,46(1):13-16
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| 球囊导管扩张联合吞咽基础训练对脑桥出血后气管切开患者吞咽功能的影响 |
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| DOI：10.3760/cma.j.issn.0254-1424.2024.01.003 |
| 中文关键词: 脑桥出血 气管切开 球囊导管扩张 吞咽训练 |
| 英文关键词: Pontine hemorrhage Tracheotomy Balloon catheter dilatation Swallowing training |
| 基金项目:山东省中医药科技项目（Q-2022100） |
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| 中文摘要: |
| 目的 观察球囊导管扩张联合吞咽基础训练对脑桥出血后气管切开患者吞咽功能的影响。 方法 选取脑桥出血气管切开吞咽障碍患者40例，按随机数字表法分为观察组和对照组，每组患者20例。2组患者均采用营养神经药物联合吞咽基础训练进行治疗，观察组则在此基础上增加球囊导管扩张技术进行治疗。球囊导管扩张术每日1次，每次25 min，每周5 d，连续治疗6周。于治疗前和治疗6周后（治疗后）由1名吞咽治疗师于双盲状态下采用功能性经口摄食(FOIS)评级和Rosenbek渗漏/误吸评分量表（PAS）评级分别评估2组患者的进食能力和渗漏-误吸情况，并采用洼田饮水实验评估2组患者治疗后的疗效。 结果 治疗后，2组患者的FOIS和PAS分级与组内治疗前比较，差异均有统计学意义（P＜0.05），且观察组治疗后的FOIS和PAS分级与对照组治疗后比较，差异亦均有统计学意义（P＜0.05）。治疗后，观察组的总有效率为70%，对照组的总有效率为30%，2组间差异有统计学意义（P＜0.05）。 结论 球囊导管扩张术联合吞咽训练可更好地改善脑桥出血后气切患者的吞咽功能，并提高疗效。 |
| 英文摘要: |
| Objective To observe any effect of supplementing basic swallowing training with balloon catheter dilation on the swallowing function of tracheostomy patients with pontine hemorrhage. Methods A total of 40 pontine hemorrhage patients with tracheostomy and swallowing disorders were divided randomly into an observation group and a control group, each of 20. Both groups were given nutritional neurodrugs and basic swallowing training, but the observation group also received 25 minutes of balloon catheter dilation, five times a week for 6 weeks. Before and after the 6 weeks of treatment one swallowing therapist evaluated the feeding ability and leakage-aspiration status of each subject assigning functional oral intake (FOIS) ratings and Rosenbek Leakage/Aspiration Rating Scale (PAS) ratings double-blinded. The Watian water swallowing test was also applied. Results After the treatment the average FOIS and PAS scores of both groups had improved significantly, with those of the observation group then significantly better than among the control group on average. The total treatment effectiveness rate was 70% in the observation group, significantly better than the 30% in the control group. Conclusion Supplementing swallowing training with balloon catheter dilation can better improve the swallowing of patients recovering from a tracheotomy after pontine hemorrhage. |
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