中医特色整体护理结合康复训练对脑卒中后吞咽困难患者的影响
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摘要
目的:探讨中医特色整体护理结合康复训练对脑卒中后吞咽困难患者治疗效果的影响。方法:将95例患者根据干预方法的不同分为2组。对照组47例,给予常规康复训练,观察组48例在对照组的基础上给予中医特色整体护理。干预1个月后,比较2组治疗效果,干预前后症状评分、饮水试验功能评分、反复唾液吞咽试验次数、吞咽X线电视透视检查(VFSS)评分、改良Barthel指数(MBI),护理满意率及并发症发生率。结果:总有效率观察组为93.75%,对照组为76.60%,2组比较差异有统计学意义(P<0.05)。症状评分、饮水试验功能评分、反复唾液吞咽试验次数、VFSS评分、MBI指数及FIM评分治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较差异也有统计学意义(P<0.05)。观察组护理满意率为93.75%,并发症发生率为8.33%;观察组护理满意率为78.72%,并发症发生率为27.66%,2组比较差异均有统计学意义(P<0.05)。结论:中医特色整体护理结合康复训练可有效改善患者吞咽困难症状,患者满意率较高,并发症少。
Objective:To explore the effects of TCM-featured holistic nursing joined with rehabilitation training on therapeutic effects for dysphagia in post-stroke patients. Methods: According to intervention methods, 95 patients were assigned into two groups. All 47 cases of the control group accepted conventional rehabilitation training, 48 cases of the observation group received TCM-featured holistic nursing on the basis of the therapy the control group accepted, after intervened for one month, to compared therapeutic effects, symptom scores before and after intervention, the scores of drinking test, the times of repeate salivary swallowing test, VFSS scores, modified Barthel index(MBI), nursing satisfaction degree and the incidence of the complications. Results: Total effective rate of the observation group was 93.75%, higher than 76.60% of the control group, and the difference showed statistical meaning(P<0.05). The difference was statistically significant in the comparisons of symptom scores, the scores of drinking test, the times of repeated salivary swallowing test, VFSS scores, MBI and FIM scores within two groups before and after treating(P<0.05); the difference had statistical meaning in the comparisons between both groups after treating(P <0.05). Nursing satisfaction degree of the observation group was 93.75%, the incidence of complications was 8.33%; higher than 78.72% and 27.66% of the control group, and there were the significant differences(P <0.05). Conclusion: TCM-featured holistic nursing joined with rehabilitation training could effectively improve the symptoms of dysphagia in post-stroke patients with higher satisfaction degree and fewer complications.
Objective:To explore the effects of TCM-featured holistic nursing joined with rehabilitation training on therapeutic effects for dysphagia in post-stroke patients. Methods: According to intervention methods, 95 patients were assigned into two groups. All 47 cases of the control group accepted conventional rehabilitation training, 48 cases of the observation group received TCM-featured holistic nursing on the basis of the therapy the control group accepted, after intervened for one month, to compared therapeutic effects, symptom scores before and after intervention, the scores of drinking test, the times of repeate salivary swallowing test, VFSS scores, modified Barthel index(MBI), nursing satisfaction degree and the incidence of the complications. Results: Total effective rate of the observation group was 93.75%, higher than 76.60% of the control group, and the difference showed statistical meaning(P<0.05). The difference was statistically significant in the comparisons of symptom scores, the scores of drinking test, the times of repeated salivary swallowing test, VFSS scores, MBI and FIM scores within two groups before and after treating(P<0.05); the difference had statistical meaning in the comparisons between both groups after treating(P <0.05). Nursing satisfaction degree of the observation group was 93.75%, the incidence of complications was 8.33%; higher than 78.72% and 27.66% of the control group, and there were the significant differences(P <0.05). Conclusion: TCM-featured holistic nursing joined with rehabilitation training could effectively improve the symptoms of dysphagia in post-stroke patients with higher satisfaction degree and fewer complications.
引文
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[4]魏海棠,彭涛,杨丹,等.针灸结合康复训练治疗脑卒中后吞咽困难的临床观察[J].中国中医急症,2015,24(10):1808-1810.
[5]张艳明.高压氧联合针灸治疗急性脑卒中后吞咽障碍效果观察[J].现代中西医结合杂志,2017,26(2):167-169.
[6]彭银英,朱乐英,叶日春.标准摄食锻炼方案在脑卒中吞咽障碍患者中的运用效果[J].临床与病理杂志,2017,37(3):467-472.
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[9]刘玉梅,陈佳伟,王思连,等.针刺结合功能性电刺激对急性脑卒中后吞咽困难患者吞咽功能的影响[J].现代生物医学进展,2016,16(14):2676-2678.
[10]杨祖愔,车晓艳,濮红萍.功能训练结合高压氧治疗脑卒中后吞咽障碍患者的临床观察[J].实用老年医学,2014,25(9):731-733.
[11]安晓蕾,李彦梅,申晓玲,等.针灸电刺激联合康复训练及心理护理在脑卒中吞咽功能障碍患者中的应用研究[J].山西医药杂志,2015,27(15):1833-1836.
[12]陈裕彬,赖瑞美,曹淑华,等.深刺廉泉为主配合吞咽康复训练治疗脑卒中后吞咽功能障碍临床研究[J].国际中医中药杂志,2017,39(9):785-788.
[13]张生玉,刘哨兵,吴伟,等.Vitalstim穴位电针法联合康复训练治疗脑卒中后吞咽障碍的疗效观察[J].针刺研究,2017,42(2):168-172.
[14]蒋娟,封爱婷.中西医结合卒中单元对脑卒中急性期患者的护理干预[J].西部中医药,2011,24(9):86-87.
[15]姜润哲,王鹏琴.眼针结合康复训练治疗脑卒中后吞咽困难临床观察[J].针灸临床杂志,2016,32(10):12-15.
[16]尹昕,梁庆成.脑卒中后吞咽困难的研究进展[J].临床神经病学杂志,2016,29(5):395-397.
[17]刘颖,李翔宇,汤宇,等.中医康复护理对脑卒中患者65例吞咽障碍的影响[J].山西医药杂志,2016,45(11):1351-1353.
[18]陈嘉汇,黄玉萍,周建仪,等.中医整体护理在急性缺血性脑卒中患者中的应用[J].中国中医急症,2017,25(10):1877-1880.
[19]佟帅,吕海波,刘建桥.针刺结合吞咽功能训练治疗脑卒中后(咽期)吞咽障碍临床疗效观察[J].中医药学报,2014,25(2):129-131.
[2]李西兄.早期康复介入对急性脑卒中偏瘫患者运动功能的影响[J].西部中医药,2013,26(7):107-108.
[3]庄淑美,吕海波,刘建桥.针刺结合康复训练治疗脑卒中后吞咽困难疗效观察[J].中国中医基础医学杂志,2013,18(7):847-848.
[4]魏海棠,彭涛,杨丹,等.针灸结合康复训练治疗脑卒中后吞咽困难的临床观察[J].中国中医急症,2015,24(10):1808-1810.
[5]张艳明.高压氧联合针灸治疗急性脑卒中后吞咽障碍效果观察[J].现代中西医结合杂志,2017,26(2):167-169.
[6]彭银英,朱乐英,叶日春.标准摄食锻炼方案在脑卒中吞咽障碍患者中的运用效果[J].临床与病理杂志,2017,37(3):467-472.
[7]陈鸣,孙定炯.吞咽康复分期针刺治疗对脑卒中吞咽障碍的临床观察[J].海南医学,2017,28(9):1504-1505.
[8]李坤彬,姚先丽,李坤霞.冰刺激联合康复训练治疗卒中后吞咽困难疗效观察[J].中华全科医学,2014,12(5):685-687.
[9]刘玉梅,陈佳伟,王思连,等.针刺结合功能性电刺激对急性脑卒中后吞咽困难患者吞咽功能的影响[J].现代生物医学进展,2016,16(14):2676-2678.
[10]杨祖愔,车晓艳,濮红萍.功能训练结合高压氧治疗脑卒中后吞咽障碍患者的临床观察[J].实用老年医学,2014,25(9):731-733.
[11]安晓蕾,李彦梅,申晓玲,等.针灸电刺激联合康复训练及心理护理在脑卒中吞咽功能障碍患者中的应用研究[J].山西医药杂志,2015,27(15):1833-1836.
[12]陈裕彬,赖瑞美,曹淑华,等.深刺廉泉为主配合吞咽康复训练治疗脑卒中后吞咽功能障碍临床研究[J].国际中医中药杂志,2017,39(9):785-788.
[13]张生玉,刘哨兵,吴伟,等.Vitalstim穴位电针法联合康复训练治疗脑卒中后吞咽障碍的疗效观察[J].针刺研究,2017,42(2):168-172.
[14]蒋娟,封爱婷.中西医结合卒中单元对脑卒中急性期患者的护理干预[J].西部中医药,2011,24(9):86-87.
[15]姜润哲,王鹏琴.眼针结合康复训练治疗脑卒中后吞咽困难临床观察[J].针灸临床杂志,2016,32(10):12-15.
[16]尹昕,梁庆成.脑卒中后吞咽困难的研究进展[J].临床神经病学杂志,2016,29(5):395-397.
[17]刘颖,李翔宇,汤宇,等.中医康复护理对脑卒中患者65例吞咽障碍的影响[J].山西医药杂志,2016,45(11):1351-1353.
[18]陈嘉汇,黄玉萍,周建仪,等.中医整体护理在急性缺血性脑卒中患者中的应用[J].中国中医急症,2017,25(10):1877-1880.
[19]佟帅,吕海波,刘建桥.针刺结合吞咽功能训练治疗脑卒中后(咽期)吞咽障碍临床疗效观察[J].中医药学报,2014,25(2):129-131.