电刺激联合吞咽康复训练与卒中后肺炎的关系(1)
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[摘要] 目的 观察经皮电刺激联合吞咽康复治疗对吞咽障碍的疗效以及卒中后肺炎发生率的影响。 方法 有吞咽障碍的脑卒中患者188例，作为吞咽治疗组；同期收治的有吞咽障碍脑卒中患者196例，作为联合治疗组；入院后拒绝吞咽康复治疗有吞咽障碍的患者79例，作为对照组。统计治疗前及治疗后3周吞咽评分、肺炎发生率，进一步随访出院后3个月内新发肺炎发生率。 结果 经过3周的治疗，联合治疗组吞咽障碍治疗的有效率高于吞咽治疗组(P = 0.041)及对照组(P = 0.001)，吞咽治疗组吞咽障碍治疗的有效率高于对照组(P = 0.001)；联合治疗组3周内罹患肺炎的患者低于吞咽治疗组(P = 0.049)及对照组(P = 0.001)，联合治疗组及吞咽治疗组出院后3个月新发肺炎的患者均明显低于对照组(P = 0.029、0.006)。 结论 电刺激法联合吞咽康复治疗能明显改善吞咽功能，同时也可以减少急性期和慢性期的肺炎发生率。
[关键词] 脑卒中；肺炎；吞咽障碍
[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210(2012)01(b)-069-03
Relationship between combined treatment of electrical stimulation and swallowing rehabilitation training and pneumonia after stroke
ZHU Haibao DU Haisong
Department of Neurology, the Central Hospital of Chengde City, Hebei Province, Chengde 067000, China
[Abstract] Objective To observe the therapeutic efficacy of transcutaneous electrical nerve stimulation combined with swallowing rehabilitation on dysphagia after stroke and its effect on pneumonia rate. Methods 188 cases of stroke patients with swallowing disorders were assigned to swallowing treatment group; 196 cases of stroke patients with dysphagia admitted in the same period were assigned to combined treatment group; 79 patients who had dysphagia but refused swallowing rehabilitation after admission were assigned to control group. Swallowing score and incidence of pneumonia 3 weeks before and after treatment were compared. And new-onset pneumonia incidence within 3 months after discharge was further followed up. Results After 3 weeks of treatment, the treatment effective rate of dysphasia was better in the combined treatment group than in the swallowing treatment group (P = 0.041) and control group (P = 0.001), with that of swallowing treatment group than that of control group (P = 0.001); 3 weeks attack rate of pneumonia was significantly lower in the combined treatment group than that in the swallowing treatment group (P = 0.049) and control group (P = 0 ......
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