吞咽与认知功能联合训练治疗脑梗死后吞咽并认知功能障碍患者疗效观察.docVIP

吞咽与认知功能联合训练治疗脑梗死后吞咽并认知功能障碍患者疗效观察 　　[摘要] 目的 探讨吞咽与认知功能联合训练治疗脑梗死后吞咽并认知功能障碍患者的疗效。 方法 选取内科就诊的脑梗死后吞咽障碍并认知功能障碍患者86例，随机分为干预组和对照组，各43例。两组均酌情予以控制颅内压、降血压、控制血糖和降血脂、拮抗血小板聚集、营养脑组织等基础治疗。对照组予以单纯的吞咽功能训练，干预组患者在对照组基础上加用认知功能训练，两组患者均干预12周。观察并比较两组患者干预前与干预12周后吞咽和认知功能指标的变化。 结果 干预12周后，两组藤氏评分较治疗前均有不同程度上升（P0.05或P0.01），且治疗后干预组藤氏评分高于对照组（P0.05）；两组LOTCA评分和积木试验评分与治疗前对比均有不同程度上升（P0.05或P0.01），且治疗后干预组LOTCA评分和积木试验评分高于对照?M（P0.05）。 结论 吞咽与认知功能联合训练治疗脑梗死后吞咽并认知功能障碍患者的疗效确切，能加快吞咽功能的提高与康复，减少或延缓其认知功能下降，改善其认知功能。 　　[关键词] 脑梗死；吞咽功能障碍；认知功能障碍；吞咽功能训练；认知功能训练 　　[中图分类号] R74 [文献标识码] B [文章编号] 1673-9701（2017）35-0075-04 　　[Abstract] Objective To investigate the curative effect of swallowing and cognitive function combined training on patients with swallowing and cognitive dysfunction after cerebral infarction. Methods A total of 86 patients with dysphagia and cognitive dysfunction after cerebral infarction admitted in the Department of Internal Medicine were selected and randomly divided into intervention group（n=43） and control group（n=43）. Both groups of patients were treated with conventional drugs for cerebral infarction， including the controls of intracranial pressure， blood pressure， blood glucose and blood lipids， anti-platelet aggregation， nourishing and protecting brain cells. The patients in the control group were trained with simple swallowing function. The patients in the intervention group were trained with cognitive function on the basis of the treatment in the control group. The two groups were intervened for 12 weeks. The changes of swallowing and cognitive function indexes were observed and compared between the two groups before and after 12 weeks of intervention. Results After 12 weeks of intervention， the vines scores of the two groups were significantly increased compared with those before intervention（P0.05 or P0.01）. The increase rate of the intervention group was more obvious than that of the control group（P0.05）. The LOTCA scores and building block scores in both groups were significantly higher t