进食体位指导联合吞咽训练在脑梗死后吞咽障碍患者中的应用

doi:10.3760/cma.j.cn441417-20250219-18025

摘要/Abstract

摘要：

目的　探讨脑梗死后吞咽障碍患者实施进食体位指导联合吞咽训练的干预效果。方法　选取驻马店市中心医院2022年10月至2024年10月收治的98例脑梗死后吞咽障碍患者进行前瞻性研究，采用随机数字表法将其分为对照组和观察组，各49例。对照组：男26例，女23例，年龄51～72（61.59±3.36）岁，采取常规干预。观察组：男27例，女22例，年龄52～71（61.68±3.40）岁，在对照组基础上采取进食体位指导联合吞咽训练。两组均持续训练干预30 d。比较两组干预前后吞咽功能恢复情况、呛咳、误吸发生率、进食情况、营养状况，以及生活质量。采用t检验、χ²检验进行统计分析。结果　干预后，观察组临床检查、饮水测试、正常进食评分均低于对照组（t=19.287、16.470、27.787，均P<0.05）；呛咳、误吸发生率均低于对照组［20.41%（10/49）比38.78%（19/49）、8.16%（4/49）比24.49%（12/49）］，差异均有统计学意义（χ²=3.967、4.781，均P<0.05）。观察组自主进食时间短于对照组，实际进食比例高于对照组（t=10.560、7.291，均P<0.05）。观察组干预后血红蛋白（Hb）、白蛋白（ALB）和前白蛋白（PA）水平均高于对照组［（118.78±12.96）g/L比（106.67±12.73）g/L、（44.70±4.38）g/L比（40.78±4.32）g/L、（245.77±25.96）mg/L比（211.15±22.59）mg/L］，差异均有统计学意义（t=4.666、4.460、7.042，均P<0.05）；吞咽生活质量量表（SWAL-QOL）中各评分均高于对照组（均P<0.05）。结论　进食体位指导联合吞咽训练能够改善脑梗死后吞咽障碍患者吞咽功能，减少呛咳、误吸等意外状况发生，促进患者更好地进食，提升患者营养状况，改善其生活质量水平。

关键词:

脑梗死, 吞咽障碍, 进食体位指导, 吞咽功能, 呛咳, 误吸

Abstract:

Objective　To explore the intervention effect of implementing eating position guidance combined with swallowing training for patients with dysphagia after cerebral infarction. Methods　A prospective study was conducted on 98 patients with post-cerebral infarction dysphagia who were admitted to Zhongshan Central Hospital in Dezhou from October 2022 to October 2024. They were randomly divided into a control group and an observation group, with 49 cases in each group using the random number table method.Control group: 26 males and 23 females, aged 51 to 72(61.59±3.36) years. Received routine intervention. Observation group: 27 males and 22 females, aged 52 to 71(61.68±3.40) years. In addition to the routine intervention, they received guidance on eating postures combined with swallowing training.Both groups underwent continuous training intervention for 30 days. The recovery of swallowing function, incidence of choking and aspiration, eating situation, nutritional status, and quality of life were compared between the two groups before and after the intervention.Statistical analysis was conducted using t-test and χ² test. Results　After the intervention, the clinical examination, water intake test and normal eating score of the observation group were all lower than those of the control group (t=19.287, 16.470, and 27.787; all P<0.05). The incidences of choking cough and aspiration were both lower in the experimental group compared to the control group [20.41% (10/49) vs. 38.78% (19/49) and 8.16% (4/49) vs. 24.49%(12/49)], and the differences were statistically significant (χ²=3.967 and 4.781; both P<0.05). The time for the observation group to achieve self-feeding was shorter than that of the control group, and the actual proportion of self-feeding was higher than that of the control group (t=10.560 and 7.291; both P<0.05). After the intervention, the levels of hemoglobin (Hb), albumin (ALB), and prealbumin (PA) in the observation group were all higher than those in the control group [(118.78±12.96) g/L vs. (106.67±12.73) g/L, (44.70±4.38) g/L vs. (40.78±4.32) g/L, and (245.77±25.96) mg/L vs. (211.15±22.59) mg/L], and the differences were statistically significant (t=4.666,4.460, and 7.042; all P<0.05).After the intervention, the scores in each item of the Specific Quality of Life Scale for Dysphagia (SWAL-QOL) in the observation group were all higher than those in the control group (all P<0.05). Conclusion　Guidance on eating postures combined with swallowing training can improve the swallowing function of patients with post-stroke dysphagia, reduce the occurrence of choking and aspiration and other accidents, facilitate better eating for patients, enhance their nutritional status, and improve their quality of life.

Key words:

Cerebral infarction, Dysphagia, Eating position guidance, Swallowing function, bucking, aspiration

仲慧刘丹周佳李霞.

进食体位指导联合吞咽训练在脑梗死后吞咽障碍患者中的应用 [J]. 国际医药卫生导报, 2025, 31(18): 3117-3121.

Zhong Hui, Liu Dan, Zhou Jia, Li Xia.

Application of eating posture guidance combined with swallowing training in patients with dysphagia after cerebral infarction [J]. International Medicine and Health Guidance News, 2025, 31(18): 3117-3121.

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