Bakhtiyari Jalal, Sarraf Payam, Nakhostin-Ansari Noureddin, Tafakhori Abbas, Logemann Jeri, Faghihzadeh Soghrat, Harirchian Mohammad Hossein
Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Iranian Center of Neurological Researches AND Department of Neurology, School of Medicine, Tehran University of Medical Sciences. Tehran, Iran.
Iran J Neurol. 2015 Jul 6;14(3):119-24.
Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke.
Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ(2) tests.
Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002.
Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia.
吞咽困难在中风后很常见。中风后吞咽康复的开始时间对吞咽困难的恢复及其并发症的预防具有重要作用，但在以往的试验中，其开始时间要么差异很大，要么未作说明。本研究的目的是调查吞咽治疗开始时间对中风后吞咽困难恢复的影响。
60例年龄在60 - 74岁（67.1±3.8）的中风后吞咽困难患者参与了这项随机临床试验研究。根据中风后吞咽治疗开始的时间，将患者分为早期、中期和晚期组。在进行基本临床和视频透视吞咽研究评估后，开始每周进行3次传统吞咽治疗，持续3个月。观察指标包括西北吞咽困难患者检查表、功能性经口进食量表、视频透视检查以及肺炎发生频率。采用重复测量方差分析、Bonferroni检验和χ²检验进行统计分析。
三组患者在人口统计学和临床特征方面，治疗前相似（P>0.050）。中风后吞咽治疗的开始时间对主要观察变量的吞咽恢复有影响。第一组患者的恢复情况优于其他组（P<0.050）。此外，早期组的肺炎发生率低于其他组，且早期组无患者发生肺炎（P = 0.002）。
我们的数据表明，中风后吞咽困难的早期干预对吞咽困难的恢复以及预防诸如吸入性肺炎等并发症具有重要作用。
