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舌下滴注阿托品眼药水治疗中风后流涎:一项随机对照试验。

Sublingual administration of atropine eye drops for treating sialorrhea after stroke: A randomized controlled trial.

机构信息

From the Rehabilitation Department,Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang City, China.

Operating Room, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang City, China.

出版信息

J Stroke Cerebrovasc Dis. 2024 Dec;33(12):108050. doi: 10.1016/j.jstrokecerebrovasdis.2024.108050. Epub 2024 Oct 2.

Abstract

BACKGROUND

Sialorrhea is a common concern in patients with swallowing disorders after stroke. Atropine sulfate blocks the muscarinic receptors in the salivary glands and leads to reduced saliva production.

OBJECTIVE

The present study aimed to assess the safety, efficacy, and tolerability of sublingual administration of atropine eye drops for treating sialorrhea after stroke.

DESIGN

This was a prospective cohort study.

SETTING

This study was conducted at Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei Province, China.

POPULATION

Stroke patients with sialorrhea were analyzed.

METHODS

One hundred stroke patients with sialorrhea were randomly assigned to the control group and the test group (n = 50 per group). The control group received routine swallowing rehabilitation training and neuromuscular electrical stimulation. The test group received therapy with 1% atropine eye drops, wherein one drop was administered sublingually 3 times per day. The Sialorrhea Scoring Scale and the incidence of adverse events were used to compare the severity of sialorrhea in the two groups.

RESULTS

The mean (standard deviation) sialorrhea score improved from 5.12 for the control group with routine rehabilitation training to 3.94 for the test group with atropine eye drop administration (P < 0.01). No significant differences in the incidence of adverse events were observed between the two groups.

CONCLUSIONS

The sublingual administration of 1% atropine eye drops three times per day can reduce the degree of sialorrhea to an extent more than that achieved with routine rehabilitation training; thus, this approach is effective, safe, and minimally invasive for treating sialorrhea after stroke.

摘要

背景

涎液过多是中风后吞咽障碍患者常见的问题。硫酸阿托品通过阻断唾液腺中的毒蕈碱受体来减少唾液分泌。

目的

本研究旨在评估舌下给予硫酸阿托品滴眼剂治疗中风后涎液过多的安全性、疗效和耐受性。

设计

这是一项前瞻性队列研究。

地点

本研究在中国湖北省湖北医药学院附属襄阳第一人民医院进行。

人群

中风后涎液过多的患者进行分析。

方法

将 100 例中风后涎液过多的患者随机分为对照组和试验组(每组 50 例)。对照组接受常规吞咽康复训练和神经肌肉电刺激。试验组接受 1%硫酸阿托品滴眼剂治疗,每天舌下含服 1 滴,每天 3 次。采用涎液评分量表和不良反应发生率来比较两组涎液过多的严重程度。

结果

接受常规康复训练的对照组涎液评分从 5.12 平均(标准差)改善至接受硫酸阿托品滴眼剂治疗的试验组的 3.94(P<0.01)。两组不良反应发生率无显著差异。

结论

每日 3 次舌下给予 1%硫酸阿托品滴眼剂可在一定程度上减轻涎液过多的程度,超过常规康复训练的效果;因此,这种方法对于治疗中风后涎液过多是有效、安全和微创的。

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