Abstract:

Objective　To explore the effect of pharyngeal ice stimulation combined with feeding training on the movement of hyoid laryngeal complex in patients with dysphagia after stroke. Methods　A total of 102 patients with dysphagia after stroke admitted to Jinan Second People's Hospital from January 2018 to December 2021 were selected and divided into a treatment group and a control group by the computer random number method, with 51 cases in each group. In the control group, there were 30 females and 21 males who were (63.52±9.63) years old. There were 31 females and 20 males in the treatment group who were (62.36±9.12) years old. The control group took feeding training; the treatment group took pharyngeal ice stimulation and feeding training. The scores of Video Fluoroscopic Swallowing Study (VFSS) and hyoid laryngeal complex movement before and 4 weeks after the treatment and adverse events were compared between the two groups. t test, χ² test, and Fisher's exact test were applied. Results　There was no statistical difference in the VFSS score between the treatment group and the control group before the training [(2.69±0.34) vs. (2.85±0.41); P>0.05]. After the training, there was a statistical difference in the VFSS score between the treatment group and the control group [(7.96±1.25) vs. (5.62±1.02); t=10.358, P<0.001]. Before the training, there were no statistical differences in hyoid bone movement and hyoid bone movement between the two groups (both P>0.05). After the training, the anterior and upper hyoid displacement distances of the two groups were higher than those before the training. After the training, the anterior and upper hyoid displacement distances of the treatment group were longer than those of the control group (t=5.296 and 9.107; both P<0.001). The incidence of adverse events in the treatment group was lower than that in the control group [1.96% (1/51) vs. 13.73% (7/51); P=0.027]. Conclusion　Pharyngeal ice stimulation combined with feeding training for patients with dysphagia after stroke is helpful to improve their swallowing function and movement of hyoid laryngeal complex and to reduce the incidence of adverse events.

Key words:

 , Stroke, Dysphagia, Pharyngeal ice stimulation, Feeding training, Incidence of adverse events

摘要：

目的　探究咽部冰刺激联合摄食训练应用于脑卒中后吞咽障碍患者对舌骨喉复合体动度的影响。方法　选取济南市第二人民医院2018年1月至2021年12月收治的102例脑卒中后吞咽障碍患者，以电脑随机数字表法将其分为治疗组和对照组，各51例。对照组女30例，男21例，年龄（63.52±9.63）岁；治疗组女31例，男20例，年龄（62.36±9.12）岁。对照组予以摄食训练，治疗组予以咽部冰刺激联合摄食训练。比较两组患者训练前及治疗4周后视频透视吞咽检查（VFSS）评分、舌骨喉复合体动度及不良事件。采用t检验、χ²检验、Fisher确切概率法进行组间统计学比较。结果　训练前后治疗组的VFSS评分分别为（2.69±0.34）、（7.96±1.25）分，对照组分别为（2.85±0.41）、（5.62±1.02）分，训练前两组患者VFSS评分比较差异无统计学意义（P>0.05），训练后两组患者的VFSS评分均高于训练前，且训练后治疗组VFSS评分高于对照组（t=10.358，P<0.001）。两组患者训练前舌骨前移、舌骨上移比较，差异均无统计学意义（均P>0.05）；训练后，两组患者的舌骨前移、舌骨上移距离均高于训练前；且训练后治疗组舌骨前移、舌骨上移距离长于对照组（t=5.296、9.107，均P<0.001）。治疗组不良事件发生率为1.96%（1/51），对照组不良事件发生率为13.73%（7/51），治疗组不良事件发生率低于对照组（P=0.027）。结论　咽部冰刺激联合摄食训练应用于脑卒中后吞咽障碍患者，有助于提高患者吞咽功能，改善舌骨喉复合体动度，降低不良事件发生率。

关键词:

脑卒中, 吞咽障碍, 咽部冰刺激, 摄食训练, 不良事件发生率