脑卒中后吞咽障碍及流涎患者的口腔感知觉训练

戴苏云; 向文海; 崔丽笙; 欧阳玉臣; 丁洁; 封慧萍; 董家豪

doi:10.7619/jcmp.20213872

脑卒中后吞咽障碍及流涎患者的口腔感知觉训练

Oral sensation training in patients with dysphagia and salivation after stroke

摘要

摘要:
目的观察口腔感知觉训练对脑卒中后吞咽障碍及流涎的疗效。
方法将79例脑卒中后吞咽障碍并伴有流涎的患者随机分为对照组39例和观察组40例。对照组患者接受神经肌肉电刺激(NMES)和常规吞咽治疗，观察组在对照组基础上辅以口腔感知觉训练。治疗前后分别采用功能性经口摄食量表(FOIS)及教师流涎分级法(TDS)评估2组患者的吞咽功能及流涎情况。治疗后3、6个月进行随访，分别评估疗效。
结果治疗前, 2组FOIS、TDS分级比较，差异无统计学意义(P>0.05); 治疗后, 2组患者FOIS分级均高于治疗前, TDS分级均低于治疗前，差异有统计学意义(P < 0.05); 观察组治疗后的FOIS分级高于对照组, TDS分级低于对照组，差异有统计学意义(P < 0.05)。治疗后3、6个月随访，观察组的有效率均高于对照组，差异有统计学意义(P < 0.05)。
结论在NMES和常规吞咽治疗的基础上辅以口腔感知觉训练，能显著改善脑卒中后患者吞咽功能和流涎情况。

Abstract:
Objective To observe effect of oral sensation training on dysphagia and salivation after stroke.
Methods A total of 79 patients with dysphagia and salivation after stroke were randomly divided into control group (39 cases) and observation group (40 cases). The patients in the control group were treated with neuromuscular electrical stimulation (NMES) and routine deglutition therapy, and the patients in the observation group were given oral sensation training on the basis of the control group. Functional oral intake scale (FOIS) and salivation rating scale (TDS) were used to evaluate the swallowing function and salivation of the two groups before and after treatment. After 3 to 6 months of treatment, the patients were followed up, the effects of the patients were evaluated.
Results There were no significant differences in the scores of FOIS and TDS between the two groups before treatment (P>0.05). The grading of FOIS in the observation group was greatly improved after treatment, and grading of TDS was lower than that of the control group (P < 0.05). After 3 to 6 months of follow-up, the total effective rate of the observation group was higher than that of the control group (P < 0.05).
Conclusion NMES and routine deglutition therapy combined with sensory training can significantly improve deglutition and salivation after stroke.

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