Abstract:

Objective　To investigate the effect of sprayed acid and cold stimulation on improving the swallowing function in stroke patients with dysphagia. Methods　It was a randomized controlled trial. A total of 81 stroke patients with dysphagia admitted to Department of Neurology, Jieyang People's Hospital from November 2020 to June 2022 were selected as the study subjects, and were divided into a control group (40 cases) and an observation group (41 cases) by the random number table method. In the control group, there were 21 males and 19 females, aged (69.85±9.74) years; in the observation group, there were 27 males and 14 females, aged (70.02±9.63) years. On the basis of conventional treatment and nursing, the control group was treated with acid and iced cotton stick stimulation rehabilitation therapy, while the observation group was treated with sprayed acid and cold stimulation rehabilitation therapy. Standardized Swallowing Assessment (SSA) score was used to compare the swallowing function of the two groups before intervention, one week after intervention, and two weeks after intervention, and the differences of comfort level and operation duration were compared between the two groups.Independent sample t test or analysis of variance were used for the measurement data, and χ² test was used for the count data. Results　Before intervention, there was no statistically significant difference in the SSA score between the two groups (P>0.05). One week and two weeks after intervention, the SSA scores of the observation group [(23.90±4.44) points and (21.05±3.32) points] were significantly lower than those of the control group [(27.55±4.64) points and (26.05±4.72) points], with statistically significant differences (both P<0.001). The scores of pharyngeal pain and nausea/discomfort in the observation group [(0.27±0.09) points and (0.60±0.09) points] were significantly lower than those in the control group [(0.80±0.11) points and (1.58±0.20) points], with statistically significant differences (both P<0.001). There was no statistically significant difference in the oropharyngeal discomfort score between the two groups (P>0.05). The operation duration of the observation group [(1 111.29±241.44) s] was significantly shorter than that of the control group [(1 244.25±323.27) s], with a statistically significant difference (t=2.101, P=0.039). Conclusion　Sprayed acid and cold stimulation is simple to operate, can improve the patients' comfort level, shorten the operation duration, and effectively improve the patients' swallowing function, which can provide references for the rehabilitation training in stroke patients with dysphagia.

Key words:

Stroke, Dysphagia, Recovery, Acid and cold stimulation, Spray

摘要：

目的　探讨喷雾式酸冷刺激改善脑卒中吞咽障碍患者吞咽功能的应用效果。方法　本研究为随机对照试验。选取2020年11月至2022年6月揭阳市人民医院神经内科收治的81例脑卒中吞咽障碍患者作为研究对象，按随机数字表法分为对照组（40例）和观察组（41例）。对照组男21例、女19例，年龄（69.85±9.74）岁；观察组男27例、女14例，年龄（70.02±9.63）岁。在常规治疗护理基础上，对照组采用酸冰棉棒刺激康复疗法，观察组采用喷雾式酸冷刺激康复疗法。于干预前、干预1周和干预2周时使用标准吞咽功能评定量表（SSA）比较两组吞咽功能，并比较两组舒适度、操作时长的差异。计量资料采用独立样本t检验或方差分析，计数资料采用χ²检验。结果　干预前，两组患者SSA评分比较，差异无统计学意义（P>0.05）；干预1周和干预2周后，观察组SSA评分［（23.90±4.44）分、（21.05±3.32）分］均显著低于对照组［（27.55±4.64）分、（26.05±4.72）分］，差异均有统计学意义（均P<0.001）。观察组咽部疼痛、恶心不适评分［（0.27±0.09）分、（0.60±0.09）分］均显著低于对照组［（0.80±0.11）分、（1.58±0.20）分］，差异均有统计学意义（均P<0.001）；两组患者口咽不适评分比较，差异无统计学意义（P>0.05）。观察组操作时间［（1 111.29±241.44）s］显著短于对照组［（1 244.25±323.27）s］，差异有统计学意义（t=2.101，P=0.039）。结论　喷雾式酸冷刺激操作简便，能提升患者舒适度，缩短操作时长，有效改善患者吞咽功能，可为脑卒中吞咽障碍患者的康复训练提供参考。

关键词:

脑卒中, 吞咽障碍, 康复, 酸冷刺激, 喷雾