【摘要】 【目的】观察交叉电项针联合吞咽训练促进卒中后气管切开患者吞咽功能及肺部感染康复的临床疗效。【方法】将60例脑卒中后气管切开合并吞咽功能障碍患者随机分为试验组和对照组,每组各30例。2组患者均给予内科基础治疗和吞咽训练,对照组给予"醒脑开窍"针刺法治疗,取内关、人中、三阴交、极泉、尺泽、委中等穴;试验组在对照组基础上加用交叉电项针治疗,采用双侧风池穴、翳风穴、地仓透颊车、廉泉穴,电极左右交叉相连;每天针刺1次,每周6次,14 d为1个疗程,共治疗2个疗程(即28 d)。在纤维内镜下对患者吞咽功能进行评价,观察2组患者治疗前后吞咽困难严重程度量表(FEDSS)、渗漏-误吸量表(PAS)及临床肺部感染评分(CPIS)的变化情况。【结果】治疗28 d后,2组患者的FEDSS、PAS、CPIS评分均较治疗前明显降低(P<0.05),且试验组的降低作用均明显优于对照组,差异均有统计学意义(P<0.05)。【结论】交叉电项针联合吞咽训练可改善卒中后气管切开患者的吞咽功能,促进咳嗽反射的恢复,有助于卒中后气管切开患者肺部感染的康复。更多还原

【Abstract】 Objective To observe the clinical effect of nape cross-electrifying electroacupuncture combined with swallowing function training on promoting the rehabilitation of swallowing function and pulmonary infection in patients with tracheotomy after stroke. Methods Sixty cases of post-stroke patients with tracheotomy complicated with dysphagia were randomly divided into the trial group and the control group,with 30 cases in each group. Both groups were given fundamental treatment of internal medicine and swallowing function training,and additionally the control group was treated with acupuncture therapy for awakening brain and inducing resuscitation on the acupoints of Neiguan(PC6),Renzhong(GV26),Sanyinjiao(SP6),Jiquan(HT1),Chize(LU5),Weizhong(BL40),and the trial group was treated with nape cross-electrifying electroacupuncture on the basis of the control group. The nape cross-electrifying electroacupuncture was performed on the acupoints of bilateral Fengchi(GB20),Yifeng(SJ17),Dicang(ST4)through Xiache(ST6),and Lianquan(CV23),and the left and right electrodes were cross-connected. The acupuncture therapy was performed once a day,6 times a week,14 days constituted a course of treatment and the treatment for the two groups lasted for 2 courses of treatment(28 days).The swallowing function of the patients was evaluated under fibro-endoscope,and the changes of fibro-endoscopic dysphagia severity scale(FEDSS) scores, penetration-aspiration scale(PAS) scores and clinical pulmonary infection scores(CPIS)in the two groups were observed before and after treatment. Results After 28 days of treatment,FEDSS scores,PAS scores and CPIS of both groups were significantly lower than those before treatment(P < 0.05),and the effect on lowering the scores in the trial group was significantly superior to that in the control group, the differences being statistically significant(P < 0.05). Conclusion The nape cross-electrifying electroacupuncture combined with swallowing function training can improve the swallowing function,promote the recovery of cough reflex,and is beneficial to the cure of pulmonary infection in patients with tracheotomy after stroke.更多还原