| 莫丹，孙莉.强化吞咽训练对脑卒中后睡眠呼吸暂停合并吞咽障碍患者的疗效[J].神经损伤功能重建,2021,16(6):319-322 |
| 强化吞咽训练对脑卒中后睡眠呼吸暂停合并吞咽障碍患者的疗效 |
| Effect of Intensive Swallowing Training on Patients with Obstructive Sleep Apnea Combinedwith Dysphagia After Stroke |
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| DOI： |
| 中文关键词: 脑卒中 吞咽障碍 多导睡眠监测 吞咽训练 |
| 英文关键词: stroke dysphagia polysomnography swallowing training |
| 基金项目:交通运输部长江航
务管理局科研项目
（No. 201910021）；
武汉市卫生健康科
研 基 金 资 助（No.
WX19D58） |
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| 中文摘要: |
| 目的：探讨强化吞咽训练对脑卒中后睡眠呼吸暂停（OSA）合并吞咽障碍患者的临床疗效。方法：纳
入符合标准的脑卒中后OSA合并吞咽障碍患者60例，随机分为对照组和强化组，各30例。2组均进行常规
吞咽康复，强化组在此基础上接受强化吞咽训练，包括强化吞咽肌群训练、神经肌肉电刺激治疗、呼吸训练
与发声训练。分别于治疗前、治疗4周后，采用洼田饮水试验、功能性经口摄食量表（FOIS）、渗透-误吸等级
量表（PAS）评估患者吞咽障碍的严重程度，包括睡眠暂停低通气指数（AHI）和平均血氧饱和度（MSaO2）。
结果：治疗前，2 组的 FOIS、PAS 评分、AHI 值和 MSaO2差异无统计学意义（P＞0.05）；治疗 4 周后，2 组的
FOIS和PAS评分均较治疗前降低（均P＜0.05），且强化组低于对照组（均P＜0.05）；强化组的AHI低于本组
治疗前及对照组（均P＜0.05），MSaO2高于本组治疗前及对照组（均P＜0.05）；对照组的AHI和MSaO2和治
疗前差异无统计学意义（均P＞0.05）；PAS评分与AHI值呈正相关性（r=0.462，P＜0.05），PAS评分与MSaO2
值无明显相关性（r=－0.046，P＞0.05）。结论：强化吞咽训练能显著改善脑卒中患者的吞咽功能及OSA症 状。 |
| 英文摘要: |
| To explore the clinical effect of intensive swallowing training on patients with obstructive sleep apnea (OSA) combined with dysphagia after stroke. Methods: A total of 60 patients with OSA and
dysphagia after stroke were included and randomly divided into the experimental group and control group with
30 patients in each. Both groups underwent conventional swallowing rehabilitation, and the experimental group
additionally received intensive swallowing training, including intensive swallowing muscle training, neuromuscular electrical stimulation therapy, breathing training, and vocal training. Before treatment and after 4 weeks of
treatment, the severity of OSA was evaluated by the water swallow test, functional oral intake classification
(FOIS) assessment, and Rosenbek penetration aspiration scale (PAS); the apnea-hypopnea index (AHI) and
mean blood oxygen saturation (MSaO2) were also measured. Results: Before treatment, there was no statistically significant difference between the two groups in FOIS score, PAS score, AHI, and MSaO2 (P>0.05). After 4
weeks of treatment, both groups showed decreased FOIS and PAS scores compared to before treatment (all P< 0.05), and the decrease was more apparent in the experimental group (all P<0.05). The AHI of the experimental
group after treatment was significantly reduced and the MSaO2 was significantly increased compared to both the
same group before treatment (all P<0.05). The AHI and MSaO2 of the control group showed no significant difference before and after treatment (all P>0.05). The PAS score showed a positive correlation with the AHI (r= 0.462, P<0.05) and no correlation with the MSaO2 (r=－ 0.046, P>0.05). Conclusion: Intensive swallowing
training can significantly improve swallowing function and reduce OSA symptoms in stroke patients. |
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