【摘要】：目的:對(duì)急性缺血性腦卒中后吞咽障礙的患者進(jìn)行針刺、神經(jīng)肌肉電刺激和康復(fù)訓(xùn)練綜合康復(fù)治療,觀察患者住院期間卒中相關(guān)性肺炎(stroke associated pneumonia,SAP)的發(fā)生率及出院后3個(gè)月內(nèi)因卒中相關(guān)性肺炎再住院率,分析綜合康復(fù)治療對(duì)卒中相關(guān)性肺炎的臨床意義。方法:135例急性缺血性腦卒中后吞咽障礙患者隨機(jī)分為綜合康復(fù)組(n=65)與對(duì)照組(n=70),對(duì)照組常規(guī)用藥物治療+康復(fù)訓(xùn)練;綜合康復(fù)組在對(duì)照組治療的基礎(chǔ)上給予針刺治療和神經(jīng)肌肉電刺激治療。統(tǒng)計(jì)兩組患者于住院治療14天時(shí)SAP發(fā)生例數(shù)、于28天時(shí)治愈SAP例數(shù)及SAP發(fā)生例數(shù),進(jìn)一步回訪兩組患者出院后3個(gè)月內(nèi)因SAP再住院例數(shù)。結(jié)果:于住院14天時(shí)兩組SAP發(fā)生率相近,無明顯統(tǒng)計(jì)學(xué)差異(P0.05);于住院28天時(shí),SAP發(fā)生率小于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),且綜合康復(fù)組SAP治愈率高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);出院后3個(gè)月內(nèi)綜合康復(fù)組因SAP再住院率明顯小于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:卒中后吞咽障礙的綜合康復(fù)治療對(duì)于改善吞咽功能、縮短吞咽障礙的病程、降低SAP發(fā)生率、促進(jìn)SAP愈合及出院后3個(gè)月內(nèi)因SAP再住院率有重要意義。
[Abstract]:Objective: to observe the effect of acupuncture, neuromuscular electrical stimulation and rehabilitation training on patients with dysphagia after acute ischemic stroke, and to observe the (stroke associated pneumonia, of stroke associated pneumonia during hospitalization. The incidence of SAP and the rehospitalization rate of apoplectic pneumonia within 3 months after discharge from hospital. The clinical significance of comprehensive rehabilitation therapy for stroke associated pneumonia was analyzed. Methods: 135 patients with dysphagia after acute ischemic stroke were randomly divided into comprehensive rehabilitation group (n = 65) and control group (n = 70). The comprehensive rehabilitation group was treated with acupuncture and neuromuscular electrical stimulation on the basis of control group. The number of SAP cases at 14 days after hospitalization, the number of cured SAP cases and the number of SAP cases in 28 days were counted. The patients in the two groups were re-hospitalized because of SAP within 3 months after further visit. Results: the incidence of SAP in the two groups was similar after 14 days of hospitalization, but there was no significant difference between the two groups (P0.05). At 28 days of hospitalization, the incidence of SAP was lower than that of the control group, the difference was statistically significant (P0.05), and the cure rate of SAP in the comprehensive rehabilitation group was higher than that in the control group, the difference was statistically significant (P0.05). The rate of rehospitalization due to SAP in the comprehensive rehabilitation group was significantly lower than that in the control group within 3 months after discharge (P0.05). Conclusion: comprehensive rehabilitation therapy for dysphagia after stroke is of great significance in improving swallowing function shortening the course of dysphagia reducing the incidence of SAP and promoting the healing of SAP and the readmission rate of SAP within 3 months after discharge from hospital.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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