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吞咽训练对中风后住院患者的疗效。

Efficacy of swallowing training for residents following stroke.

作者信息

Lin Li-Chan, Wang Shu-Chen, Chen Seng Hwa, Wang Tyng-Guey, Chen Miao-Yen, Wu Shiao-Chi

机构信息

Professor, Institute of Clinical Nursing, National Yang-Ming University, Taipei, Taiwan.

出版信息

J Adv Nurs. 2003 Dec;44(5):469-78. doi: 10.1046/j.0309-2402.2003.02830.x.

Abstract

BACKGROUND

The presence of dysphagia is associated with an increased risk of mortality, malnutrition, dehydration, compromised pulmonary function, and disability. Appropriate swallowing training can establish optimal nutritional status and eliminate or reduce the risk of developing medical complications associated with swallowing impairment.

AIM(S) OF THE STUDY: The aim of this study was to examine the functional swallowing and nutritional outcomes of swallowing training in institutionalized stroke residents with dysphagia.

DESIGN AND METHODS

A quasi-experimental parallel cluster design was used. Seven institutions with similar bed sizes were selected. All subjects in the experimental group received a structured swallowing training programme. The subjects in the experimental group (n = 40) received 30 minutes of swallowing training each day for 6 days per week for 8 weeks. The control group (n = 21) did not receive any training.

RESULTS

After swallowing training, mean differences in volume per second, volume per swallow, mid-arm circumference and body weight between pre- and post-training of the experimental group were significantly higher than for the control group, while mean differences in neurological examination and choking frequency during meals for the experimental group were significantly lower than in the control group.

CONCLUSION

This study used objective timed swallowing tests, a swallowing questionnaire, and a neurological examination to evaluate the effects of swallowing training. However, videofluroscopy is generally considered the best method for evaluating the pharyngeal and esophageal stages of swallowing, and introducing this technique is recommended for future studies. Furthermore, it is recommended that nursing professionals should conduct swallowing training protocols in stroke patients to help prevent aspiration from dysphagia.

摘要

背景

吞咽困难的存在与死亡、营养不良、脱水、肺功能受损及残疾风险增加相关。适当的吞咽训练可建立最佳营养状况,并消除或降低与吞咽障碍相关的医学并发症发生风险。

研究目的

本研究旨在探讨吞咽训练对机构化吞咽困难脑卒中患者吞咽功能及营养状况的影响。

设计与方法

采用准实验平行整群设计。选取7家床位规模相似的机构。实验组所有受试者接受结构化吞咽训练计划。实验组受试者(n = 40)每天接受30分钟吞咽训练,每周6天,共8周。对照组(n = 21)未接受任何训练。

结果

吞咽训练后,实验组训练前后每秒吞咽量、每口吞咽量、上臂中部周长及体重的平均差异显著高于对照组,而实验组进餐时神经学检查及呛咳频率的平均差异显著低于对照组。

结论

本研究采用客观定时吞咽测试、吞咽问卷及神经学检查评估吞咽训练效果。然而,视频荧光吞咽造影检查通常被认为是评估吞咽咽期和食管期的最佳方法,建议未来研究引入该技术。此外,建议护理专业人员对脑卒中患者实施吞咽训练方案,以帮助预防吞咽困难引起的误吸。

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