吞咽治疗仪联合肠内营养治疗卒中后延髓麻痹吞咽障碍的临床研究

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1、吞咽治疗仪联合肠内营养治疗卒中后延髓麻痹吞咽障碍的临床研究【摘要】目的观察吞咽治疗仪联合肠内营养支持对卒中后延髓麻痹咽期神经源性吞咽障碍患者的治疗效果。方法选取咽期吞咽障碍患者106例随机分为对照组、治疗仪组、肠内营养组及联合治疗组。各组患者均给了脑卒屮常规药物治疗及鼻饲营养师指导下配制的匀浆流质饮食，治疗仪组患者同时辅以吞咽治疗仪治疗,肠内营养组患者则以肠内营养制剂瑞高治疗,联合治疗组患者则同时辅以吞咽治疗仪及肠内营制剂瑞高联合治疗。分别于治疗前、后采用反复唾液吞咽测试及饮水试验评价患者吞咽功能的

2、改善情况。结果除対照组患者以外，英他各组患者吞咽功能评分均较治疗前显著改善(P治疗仪组〉肠内营养组〉对照组，差异均冇统计学意义(P<0.01)o结论吞咽治疗仪联合肠内营养治疗脑卒中后延髓麻痹所导致的吞咽障碍具有协同效应，可进一步提高临床疗效,促进患者早日康复。【关键词】吞咽治疗仪；肠内营养;延髓麻痹;吞咽障碍ClinicalStudiesofswal1owingtreatmentapparatuscombinedwithenteralnutritioninthetreatmentofdysphagi

3、acausedbybulboparalysisafterstrokeWUBang-li,LIUBo,LIUJie,etal.DepartmentofNeurology,AfiliatedZiboMunicipalFirstHospitalofWeifangMedicalCollage,Zibo255200,China【Abstract】ObjectiveToobservetheeffectivenessofswallowingtreatmentapparatusthetreatmentofdysph

4、agiastroke.MethodsOnehimdredandcombinedwithenteralnutritionincausedbybulboparalysisaftersixpationtswereremdomlydividedintocontrolgroup,apparatusgroup,entera!nutritiongroupandcombinedtreatmentgroup.Allthepatientsweregivenroutinemedicationtreatment.Inadd

5、ition,thepatientsinapparatusgroupandenteralnutritiongroupweregivenswallowingtreatmentapparatustherapyandenteralnutritiontherapy,respectively.Thepatientsincombinedtreatmentgroupweregivenswallowingtreatmentapparatustherapycombinedwithenteralnutrition.Rep

6、etitivesalivaswallowingtestandwaterdrinkingtestwereusedtoassessswallowingfunctionbeforeand21stdaftertreatment.ResultsItwasshownthatthepatientsinallgroupsbutthecontrolgroupgotsignificantimprovementinswallowingaftertreatment,asdemonstratedbytheswallowing

7、functionscores(PapparatusgrouP>enteralnutritiongrouP>controlgroup(P<0.01)•ConclusionThecombinationofswallowingtreatmentapparatustherapyandenteralnutritioncouldactsynergicallytoamelioratedysphagiacausedbybulboparalysisafterstrokeandhelppatientsrecoverso

8、on.【Keywords]Swallowingtreatmentapparatus;Enteralnutrition;Bulboparalysis;Dysphagia延髓麻痹也称为球麻痹，是常见的咽喉肌和舌肌麻痹综合征，可由于舌咽、迷走和舌下神经及核的下运动神经元病变以及双侧皮质延髓束或广泛性皮质损害所致。吞咽障碍是延9■作者单位：255200潍坊医学院附属淄傅市第一医院神经内科髓麻痹的主要特征之一。急性脑卒中后患者常出现延髓麻痹，吞咽障碍发生率高达22%'飞5%[1