Abstract:

Objective　To explore the effect of oral sensory training combined with graded feeding management on swallowing function and malnutrition risk in patients with dysphagia after stroke. Methods　From February 2022 to April 2024, 118 patients with dysphagia after stroke treated at Department of Neurology, Henan Provincial People's Hospital were selected as the study objects. The 59 patients who received routine swallowing training and nutritional intervention from February 2022 to February 2023 were set as a control group. The 59 patients who received oral sensory training and graded feeding management from March 2023 to April 2024 were set as an experimental group. There were 35 males and 24 females in the control group; they were 57-84 (69.52±3.23) years old; their disease course was 11-45 (23.89±3.27) d. There were 33 males and 26 females in the experimental group; they were 55-85 (69.85±3.42) years old; their disease course was 10-42 (23.52±3.11) d. Both groups were intervened for 30 d. The intervention effects, incidence rates of adverse events, swallowing function [score of Standardized Swallowing Assessment (SSA)], and nutritional status [total protein (TP), albumin, globulin, and serum amino acid ratio] were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate, total incidence rate of adverse events, and total score of SSA in the experimental group were better than those in the control group [94.92% (56/59) vs. 83.05% (49/59), 3.38% (2/59) vs. 15.25% (9/59), and 35.46±1.24 vs. 42.66±1.89], with statistical differences (χ²=4.236 and 4.913; t=24.466; all P<0.05). After the intervention, the levels of TP, albumin, and globulin and serum amino acid ratio in the experimental group were better than those in the control group [(61.28±7.28) g/L vs. (57.88±7.41) g/L, (31.18±4.05) g/L vs. (29.23±4.08) g/L, (26.34±3.09) g/L vs. (22.17±2.94) g/L, 1.62±0.41 vs. 2.03±0.55], with statistical differences (t=2.514, 2.605, 7.510, and 4.591; all P<0.05). Conclusion　Oral sensory training and graded feeding management for patients with dysphagia after stroke can improve their swallowing function, regulate their nutritional status, and reduce the risk of adverse events, such as malnutrition, etc.

Key words:

Stroke, Dysphagia, Oral sensory training, Graded feeding management, Swallowing function, Malnutrition risk

摘要：

目的　探讨应用口腔感觉训练结合分级喂养管理对脑卒中后吞咽障碍患者吞咽功能及营养不良风险的影响。方法　选择2022年2月至2024年4月河南省人民医院神经内科住院的118例脑卒中后吞咽障碍患者为研究对象，将2022年2月至2023年2月予以常规吞咽训练与营养干预的59例患者列为对照组，2023年3月至2024年4月予以口腔感觉训练结合分级喂养管理的59例患者列为试验组。对照组：男35例，女24例，年龄57～84（69.52±3.23）岁，病程11～45（23.89±3.27）d。试验组：男33例，女26例，年龄55～85（69.85±3.42）岁，病程10～42（23.52±3.11）d。两组干预周期均为30 d。对比两组干预效果、不良事件发生率，干预前、后两组吞咽功能［标准吞咽功能评价量表（SSA）评分）］、营养状态［血清总蛋白（TP）、白蛋白、球蛋白、血清氨基酸比值］。采用χ²检验、t检验进行统计分析。结果　干预后，试验组总有效率高于对照组［94.92%（56/59）比83.05%（49/59）］，总不良事件发生率、SSA总分均低于对照组［3.38%（2/59）比15.25%（9/59）、（35.46±1.24）分比（42.66±1.89）分］，差异均有统计学意义（χ²=4.236、4.913，t=24.466，均P<0.05）；试验组TP、白蛋白、球蛋白均高于对照组［（61.28±7.28）g/L比（57.88±7.41）g/L、（31.18±4.05）g/L比（29.23±4.08）g/L、（26.34±3.09）g/L比（22.17±2.94）g/L］，血清氨基酸比值低于对照组（1.62±0.41比2.03±0.55），差异均有统计学意义（t=2.514，2.605，7.510，4.591，均P<0.05）。结论　对脑卒中后吞咽障碍患者应用口腔感觉训练结合分级喂养管理，可改善患者吞咽功能，调节营养状况，降低营养不良等不良事件的发生风险。

关键词:

脑卒中, 吞咽障碍, 口腔感觉训练, 分级喂养管理, 吞咽功能, 营养不良风险