Wang Shuai, Feng Junyan, Bi Juan, Li Xiaoyan, Tian Jundan, Zhang Bingqian
Department of Neurology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Psychosomatic Medicine, Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua District, Shijiazhuang City, 050000, Hebei Province, China.
Eur Arch Otorhinolaryngol. 2025 May;282(5):2539-2547. doi: 10.1007/s00405-024-09112-y. Epub 2024 Dec 5.
This study evaluated the effectiveness of an enhanced dysphagia assessment method combined with dietary interventions for patients experiencing dysphagia post-stroke.
A prospective randomized controlled trial was conducted with 98 hospitalized post-stroke patients suffering from dysphagia. Participants were randomly assigned into two groups: the study group (receiving enhanced dysphagia assessment and dietary interventions) and the control group (receiving standard nursing care), using a computer-generated randomization list. Swallowing function was assessed using the Mann Assessment of Swallowing Ability (mMASA), Dysphagia Severity Scale (DSS), and Wada's water swallowing test. Additionally, quality of life and nutritional status were evaluated for both groups, before and after the intervention.
Post-intervention, the study group exhibited significantly better scores on mMASA and Wada's water swallowing test, and lower DSS scores compared to the control group (all P < 0.05). Initially, no significant differences were observed between the groups concerning aspiration symptoms, nutritional and respiratory dysfunction, psychological disorders, and total scores (all P > 0.05). However, post-intervention, the study group showed significant improvements in these parameters and lower scores compared to the control group (all P < 0.05). Additionally, the study group demonstrated higher BMI, albumin (ALB), and hemoglobin (Hb) levels post-intervention (all P < 0.05), and a markedly lower incidence of aspiration and aspiration pneumonia (all P < 0.05).
Enhanced dysphagia assessment combined with dietary interventions significantly improves swallowing function, quality of life, and nutritional status in post-stroke dysphagia patients. This approach also reduces the incidence of related complications, suggesting substantial clinical benefits.
本研究评估了强化吞咽困难评估方法联合饮食干预对中风后吞咽困难患者的有效性。
对98例住院的中风后吞咽困难患者进行了一项前瞻性随机对照试验。使用计算机生成的随机列表将参与者随机分为两组:研究组(接受强化吞咽困难评估和饮食干预)和对照组(接受标准护理)。使用曼恩吞咽能力评估(mMASA)、吞咽困难严重程度量表(DSS)和和田饮水试验评估吞咽功能。此外,在干预前后对两组的生活质量和营养状况进行了评估。
干预后,研究组在mMASA和和田饮水试验中的得分显著高于对照组,DSS得分低于对照组(均P < 0.05)。最初,两组在误吸症状、营养和呼吸功能障碍、心理障碍及总分方面无显著差异(均P > 0.05)。然而,干预后,研究组在这些参数上有显著改善,得分低于对照组(均P < 0.05)。此外,研究组干预后的体重指数(BMI)、白蛋白(ALB)和血红蛋白(Hb)水平更高(均P < 0.05),误吸和误吸性肺炎的发生率显著更低(均P < 0.05)。
强化吞咽困难评估联合饮食干预可显著改善中风后吞咽困难患者的吞咽功能、生活质量和营养状况。这种方法还可降低相关并发症的发生率,显示出显著的临床益处。