认知功能训练对脑损伤后吞咽功能障碍并发认知功能障碍患者吞咽功能改善程度影响.docVIP

认知功能训练对脑损伤后吞咽功能障碍并发认知功能障碍患者吞咽功能改善程度影响 　　摘 要 目的：观察在对脑损伤后吞咽功能障碍并发认知功能障碍患者进行康复治疗过程中认知功能训练对患者吞咽功能改善程度的影响。方法：对60例脑损伤后吞咽功能障碍患者进行综合性吞咽功能训练，对其中并发认知功能障碍的32例患者还同时进行认知功能训练。采用洼田饮水试验、标准吞咽功能评估量表和X线荧光透视吞咽检查进行吞咽功能障碍程度评定，并分析认知功能正常与障碍患者在吞咽功能改善程度上的差异。结果：经4周康复治疗，并发认知功能障碍患者的吞咽功能改善程度不如单纯吞咽功能障碍患者，但与康复治疗前相比仍较明显。结论：对并发认知功能障碍的吞咽功能障碍患者，认知功能的提高对其吞咽功能的改善也有重要意义。 　　关键词 脑损伤 吞咽功能障碍 认知功能障碍 　　中图分类号：R743.3； R493 文献标识码：B 文章编号：1006-1533（2017）13-0017-05 　　The effect of swallowing and cognitive training on dysphagia after brain injury* 　　TIAN Shan1， XU Shaohong2， HU Ruiping1， JIANG Congyu1， WU Junfa1， SHEN Xiafeng2， LI Dandan1， ZHU Yulian1， LU Weibo2， WU Yi1**（1. Department of Rehabilitation， Huashan Hospital， Fudan University， Shanghai 200040， China； 2. Department of Rehabilitation， the First Rehabilitation Hospital of Shanghai， Shanghai 200090， China） 　　ABSTRACT Objective： To analyze the effect of cognition training on the clinical efficacy in the treatment of patients with brain injury complicated with dysphagia and cognitive dysfunction. Methods： Sixty patients with dysphagia underwent comprehensive swallowing training， in which 32 cases of the patients with cognitive dysfunction also underwent cognitive training. Dysphagia degree was evaluated with water swallow test， standardized swallowing assessment and videofluoroscopic swallowing study. The differences of curative effect were compared between the patients with cognitive dysfunction or without. Results： After 4 weeks of treatment， the improvement of dysphagia in the patients complicated with cognitive dysfunction was not better than the patients with simple dysphagia， but the differences were still significant compared with the results before the therapy. Conclusion： For patients with dysphagia and cognitive dysfunction， the improvement of cognitive function is also of great significance to the improvement of swallowing function. 　　KEY WORDS brain injury； dysphagia； cognitive dysfunction 　　吞咽功能障?K是脑损伤后的常见并发症之一。据统计，脑损伤后急性期患者的吞咽功能障碍发生率为51%