早期干预对急性脑梗死后吞咽障碍患者营养状况及ADL的影响.doc

早期干预对急性脑梗死后吞咽障碍患者营养状况及ADL的影响 山东医药2010年第50卷第24期 干预对急性脑梗死后吞咽障碍患者 状况及ADL的影响 黄治飞,朱幼玲,蔡伟.朱双根,穆燕芳 (合肥市第一人民医院,合肥230061) 摘要:目-的探讨早期不同干预措施对急性脑梗死所致吞咽障碍患者的吞咽能力,营养状况及日常生活活动 能力(ADL)的影响.方法将100例急性脑梗死后吞咽障碍患者随机分为综合治疗组(康复训练联合针灸治疗), 康复训练组,针灸治疗组及常规药物组各25例,于治疗前,治疗2周后分别采用吞咽电视检查(VFSS)评价吞咽障 碍程度,检测血清白蛋白,血红蛋白,总淋巴细胞计数,采用Baahel指数分级法评价ADL.结果治疗2周后,综合 治疗组吞咽能力改善有效率优于其他3组(Plt;0.05);4组血清白蛋白,血红蛋白,总淋巴细胞计数均较治疗前下 降(Plt;0.05),但综合治疗组优于其他3组(Plt;0.05);2周后综合治疗组Baahel指数分级改善均优于其他3组(P lt;0,05).结论急性脑梗死后吞咽障碍经早期康复训练联合针灸治疗,能明显改善吞咽功能,缓解营养不良恶 化,促进患者ADL的恢复. 关键词:脑梗死;吞咽障碍;康复;针灸;日常生活活动能力 中图分类号:R743.3文献标志码:A文章编号:1002—266X(2010)24-0029-04 Effectsofearlyinterventiononstatusofnutritionandactivitiesofdailylifeinpatients withdysphagiafollowingacutecerebralinfarction HUANGZhi-fei,ZHUYou—ling,CAIWei,ZHUShuang—gen,MUYang-fang (HefeiFirstPeople’SHospital,Hefei230061,P.R.China) Abstract:0hjectiveTostudytheeffectsofearlydifferentinterventionsonswallowingfunction,statusofnutrition andactivitiesofdailylifeinpatientswithdysphagiafollowingacutecerebralinfarction.MethodsOnehundredacutecer- ebralinfarctionpatientswithdysphagiawererandomlydividedintocomprehensivetreatmentgroup(receivedrehabilitation training,acupunctureandroutinetherapyofdrug),routinedruggroup(routinetherapyofdrug),rehabilitationgroup(re- ceivedcomprehensiverehabilitationtrainingandroutinetherapyofdrug)andacupuncturegroup(receivedacupuncture therapyandroutinetherapyofdrug).Dysphagiaandnutritionalstatuswereassessedbyvideofluoroscopicswallowingstudy (VFSS).Albumin(Alb),hemoglobin(Hb),totallymphocytecount(TLC)andactivitiesofdailylifewereassessedby Barthelindexbeforetreatmentandatthe14thdayaftertreatment.ResultsAftertreatment,theeffectiverateofthecon— prehensivetreatmentgroupwassignificantlyhigherthanthoseinotherthreegroups(Plt;0.05).TheAlb,HbandTLCin thecomprehensivetreatmentgroupwerehigherthanthoseinothergroups(Plt;0.05).Barthelindexaftertreatmentwas significantlyhigherinthecomprehensivetreatmentgroupthanthatinothergroups(Plt;0.05).ConclusionsEarlyreha— bilitationtrainingplu