Department of the Second Internal Neurology, Zhumadian Central Hospital, Henan, P.R. China.
Eur Rev Med Pharmacol Sci. 2017 Dec;21(24):5711-5716. doi: 10.26355/eurrev_201712_14017.
To investigate the effects of extended in-patient training on swallowing function of patients with post-stroke dysphagia.
40 patients with post-stroke dysphagia treated between January 2013-December 2015 were randomly divided into the treatment group and the control group. During the hospitalization, patients in both groups underwent routine examinations, graded swallowing training, radio frequency electrotherapy, acupuncture, dietary guidance, body position and compensation training, etc. In addition, patients in the treatment group received training with ice stimulation. The swallowing functions and prevalence rate of adverse events of the two groups during the first three months after discharge from the hospital were compared. Twenty healthy people coming for a regular checkup during the same period were also included in this study. ELISA was used to compare the peripheral blood S100β levels of the patients with post-stroke dysphagia and the healthy population.
After 3-month follow-up, statistical analysis showed that 70.00% patients in the treatment group regained normal (excellent/very good) swallowing function, which was much higher than the normal rate of people in the control group (25%). The difference was statistically significant (χ2 = 8.12, p<0.05). Patients in the treatment had a lower prevalence rate of adverse events (e.g. aspiration, choking, aspiration pneumonia) (5.00%) lower than the control group (25.00%), and the difference was statistically significant (χ2 = 4.02, p<0.05). ELISA assay indicated that the peripheral blood S100β levels in patients with dysphagia were significantly higher than the healthy population (p<0.05). But compared with the control group, patients in the treatment group patients had lower S100β level after the treatment, and the difference was statistically significant (p<0.05).
The extended ward training could significantly improve the swallowing function of patients with post-stroke dysphagia, restore their swallowing function, and reduce adverse events of swallowing. The operations were simple, safe and practical. The training is worthy of promotion.
探讨延长住院时间对脑卒中后吞咽障碍患者吞咽功能的影响。
选取 2013 年 1 月至 2015 年 12 月收治的脑卒中后吞咽障碍患者 40 例，随机分为观察组和对照组。两组患者住院期间均接受常规检查、分级吞咽训练、射频电疗、针灸、饮食指导、体位和代偿训练等。此外，观察组患者还接受冰刺激训练。比较两组患者出院后 3 个月内的吞咽功能及不良事件发生率。同时纳入同期进行常规体检的 20 例健康人作为健康对照组。采用 ELISA 法比较脑卒中后吞咽障碍患者和健康人群的外周血 S100β 水平。
经过 3 个月的随访，观察组患者中 70.00%恢复正常（优/良）吞咽功能，明显高于对照组的 25.00%，差异有统计学意义（χ2=8.12，p<0.05）。观察组患者不良事件发生率（如呛咳、误吸、吸入性肺炎等）为 5.00%，明显低于对照组的 25.00%，差异有统计学意义（χ2=4.02，p<0.05）。ELISA 检测结果显示，脑卒中后吞咽障碍患者外周血 S100β水平明显高于健康人群（p<0.05）。与对照组比较，观察组患者治疗后 S100β水平降低，差异有统计学意义（p<0.05）。
延长住院时间的吞咽功能训练可明显改善脑卒中后吞咽障碍患者的吞咽功能，恢复其吞咽功能，减少吞咽不良事件的发生。操作简单、安全实用，值得推广。
