CAJ | 학술논문

目的探讨电视透视吞咽检查(VFSS)指导脑卒中后吞咽障碍康复治疗的应用价值.方法将80例吞咽障碍患者随机分为治疗组及对照组,2组患者入院第1天及第28天进行VFSS检查,治疗组另外每周进行1次VFSS检查.2组均接受常规肢体运动功能训练,对照组患者根据第1次VFSS检查结果选择相应训练方法及冰刺激;治疗组除给予冰刺激外,还根据每周VFSS检查结果选择对应训练方法.于治疗4周后采用饮水试验分级、吞咽障碍分级及VFSS对患者治疗前后吞咽功能进行评定.结果治疗组患者根据每周VFSS检查结果及时调整治疗方案,第2、3、4周时调整治疗方案的患者比例分别为20.6%、40.7%和15.8%.2组患者治疗前饮水试验分级、吞咽障碍分级及VFSS检查结果比较,组间差异均无统计学意义(P>0.05);经相应治疗后,发现2组患者饮水试验分级、吞咽障碍分级及碘剂口、咽通过时间均较治疗前明显好转,差异具有统计学意义(P<0.05),并且以治疗组的改善幅度较显著,与对照组比较,组间差异具有统计学意义(P<0.05).结论采用连续VFSS指导吞咽障碍康复训练具有治疗针对性强、疗效好等优点,可进一步改善脑卒中吞咽障碍患者吞咽功能,疗效明显优于传统吞咽康复治疗.
목적 탐토전시투시탄인검사(VFSS)지도뇌졸중후탄인장애강복치료적응용개치.방법 장80례탄인장애환자수궤분위치료조급대조조,2조환자입원제1천급제28천진행VFSS검사,치료조령외매주진행1차VFSS검사.2조균접수상규지체운동공능훈련,대조조환자근거제1차VFSS검사결과선택상응훈련방법급빙자격;치료조제급여빙자격외,환근거매주VFSS검사결과선택대응훈련방법.우치료4주후채용음수시험분급、탄인장애분급급VFSS대환자치료전후탄인공능진행평정.결과 치료조환자근거매주VFSS검사결과급시조정치료방안,제2、3、4주시조정치료방안적환자비례분별위20.6%、40.7%화15.8%.2조환자치료전음수시험분급、탄인장애분급급VFSS검사결과비교,조간차이균무통계학의의(P>0.05);경상응치료후,발현2조환자음수시험분급、탄인장애분급급전제구、인통과시간균교치료전명현호전,차이구유통계학의의(P<0.05),병차이치료조적개선폭도교현저,여대조조비교,조간차이구유통계학의의(P<0.05).결론 채용련속VFSS지도탄인장애강복훈련구유치료침대성강、료효호등우점,가진일보개선뇌졸중탄인장애환자탄인공능,료효명현우우전통탄인강복치료.
Objective To explore the application of videofluoroscopic swallowing study (VFSS) in the treatment of dysphagia post-stroke. Methods Eighty patients were assigned into control and treatment groups. Both groups accepted routine drug treatments and physical therapy, and all patients underwent VFSS on the 1 st and 28th day of the study. The patients in the treatment group accepted weekly VFSS in addition, and their swal-lowing training schedules were formulated according to the VFSS assessment results. Water drinking tests and de-glutition disorders were adopted to assess the patients' swallowing function before and after therapy. Results In treatment group, where the therapy schedule was adjusted using VFSS every week, the adjustment proportion at the 2nd, 3rd and 4th week was 20.6% , 40.7% and 15.8% , respectively. Before treatment there was no difference between the two groups with regard to water drinking, deglutition or VFSS scores. After training the water drinking and deglutition results and the time for iodine to transit the oral cavity and pharynx all improved significantly in both groups. The improvements in the treatment group were significantly greater than in the con-trol group. Conclusions Swallowing training based on videofluoroscopic assessment can significantly alleviate post-stroke dysphagia.