直接摄食指导结合经颅直流电刺激治疗脑卒中后吞咽障碍的临床观察及对误吸程度的影响

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摘要目的探讨直接摄食指导结合经颅直流电刺激治疗脑卒中后吞咽障碍的临床效果及对误吸程度的影响。方法选取2017年11月～2019年12月福建医科大学附属龙岩第一医院收治的80例脑卒中后吞咽障碍患者作为研究对象，按照随机信封法将其分为观察组（40例）与对照组（40例）。对照组患者采用直接摄食指导方法，观察组患者采用直接摄食指导结合经颅直流电刺激方法。比较两组患者的治疗总有效率、改良曼恩吞咽能力评估量表（MMASA）评分、功能性经口摄食量表（FIOS）评分、进食和饮水误吸发生情况。结果观察组患者的治疗总有效率高于对照组，差异有统计学意义（P<0.05）。治疗后观察组患者的MMASA及FIOS评分均高于对照组，差异有统计学意义（P<0.05）。观察组患者的饮水误吸、摄食误吸和误吸总发生率均低于对照组，差异有统计学意义（P<0.05）。结论直接摄食指导结合经颅直流电刺激治疗脑卒中后吞咽障碍患者可有效提高其吞咽功能，并显著降低患者误吸发生率。

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关键词 ：直接摄食指导, 经颅直流电刺激, 脑卒中后吞咽障碍, 误吸

Abstract：Objective To explore the clinical effect of direct feeding instruction combined with transcranial direct current stimulation in the treatment of dysphagia after stroke and its influence on the degree of aspiration.Methods Eighty patients with dysphagia after stroke admitted to Longyan First Hospital Affiliated to Fujian Medical University from November 2017 to December 2019 were selected as the research objects.According to the random envelope method,they were divided into the observation group (40 cases) and the control group (40 cases).The control group adopted the direct feeding instruction method,and the observation group adopted the direct feeding instruction combined with transcranial direct current stimulation.The total effective rate of treatment,scores of the modified Mann swallowing ability assessment scale (MMASA),the functional food intake scale (FIOS),and the occurrence of eating and drinking aspiration were compared between the two groups..Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant (P<0.05).After treatment,the MMASA and FIOS scores of the observation group were higher than those in the control group,and the differences were statistically significant (P<0.05).The rates of water aspiration,food aspiration and total aspiration of the observation group were lower than those of the control group,and the differences were statistically significant (P<0.05).Conclusion The combination of direct feeding guidance and transcranial direct current stimulation for treating patients with dysphagia after stroke can effectively improve their swallowing function and significantly reduce the incidence of aspiration in patients

Key words： Direct feeding instruction Transcranial direct current stimulation Dysphagia after stroke Aspiration

作者简介: 华何柳(1978-)，男，福建长汀人，本科，副主任医师，研究方向：神经康复、骨科康复

引用本文:

华何柳；张百祥；刘娟；唐能章；王秀玲；陈宁华. 直接摄食指导结合经颅直流电刺激治疗脑卒中后吞咽障碍的临床观察及对误吸程度的影响[J]. 中国当代医药, 2020, 27(36): 60-63.
HUA He-liu ZHANG Bai-xiang LIU Juan TANG Neng-zhang WANG Xiu-ling CHEN Ning-hua. Clinical observation of direct feeding instruction combined with transcranial direct current stimulation in the treatment of dysphagia after stroke and its influence on the degree of aspiration. 中国当代医药, 2020, 27(36): 60-63.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I36/60

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