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find Keyword "吞咽" 19 results
  • Bedside Assessment of Swallow in Stroke

    摘要:目的:探索可靠的卒中患者床旁吞咽评估方法。方法:61例住院卒中患者均进行各种床旁吞咽评估筛查及电视透视检查,以后者为金标准探讨各方法的敏感度、特异度及阳性、阴性预测值。结果:六种独立床旁吞咽评估方法与金标准相比较的敏感度在60%~87%之间,特异度在76%~89%之间,阳性预测值在50%~69%之间,阴性预测值在86%~95%之间;几种评估方法作为平行试验联合应用时的敏感度在89%~98%之间,阴性预测值在94%~99%之间;几种方法作为序列试验应用时的特异度在97%~99%之间,阳性预测值在82%~90%之间。结论:根据不同方法的预测特点,可得到针对不同患者的、有效的床旁评估方法。床旁吞咽评估简单、有效、便捷,是临床工作中适宜的评估方法。

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • Risk Factors for Stroke Associated Pneumonia: A Prospective Study

    Objective To investigate the risk factors of stroke associated pneumonia in stroke patients.Methods A case-control study was conducted. 114 patients who were diagnosed stroke associated pneumonia between January 2008 and December 2010 were recruited as a patient group. 205 patients who were diagnosed stroke without pneumoniawere recruited as a control group. General conditions, accompanied disease, vital sign, hematologic marker, severity of stroke, and bulbar paralysis were compared between two groups. Multifactor Logistic regression was used to screen associated factors.Results Age gt; 65 years ( OR=3. 310, 95% CI 2. 016-7. 549) , accompanied with COPD ( OR = 3. 624, 95% CI 1. 574-9. 236) , diabetes ( OR= 3. 781, 95% CI 1. 305-6. 842) , failed water swallowing test ( OR = 3. 625, 95% CI 1. 604- 8. 386) , big volume of stroke ( OR=14. 784, 95% CI 3. 737-38. 588) , NIH stroke scale ( NIHSS) score gt;6 ( OR=2. 913, 95% CI 1. 029-7. 985) , abbreviated mental test ( AMT) score lt; 8 ( OR = 4. 229, 95% CI 2. 215-9. 368) were associated with stroke associated pneumonia. Conclusion The risk factors for stroke associated pneumonia in stroke patients were age gt;65 years, accompanied with COPD, diabetes, failed WST, big volume of stroke, NIHSS score gt;6, and AMT score lt;8.

    Release date:2016-09-13 03:50 Export PDF Favorites Scan
  • 吞咽和咽食管段运动功能障碍的研究进展

    咽食管段 (PES)又称食管上括约肌 (UES) ,是位于咽与食管间的一个高压区。 PES的横纹肌和环状软骨、甲状软骨、舌骨及其韧带和舌骨上、下肌群共同构成了一个控制食管入口开闭的功能单位。 PES的 3个主要功能为 :在两次吞咽间保持食管开口处于关闭状态 ;吞咽时使食管张开 ;参与其上方的咽缩肌及下方的颈段食管对食团的运输。如果这 3种功能的任何一个环节出现不协调 ,将导致吞咽障碍。 PES的张力不足将导致 U ES弛张症 ,常由于累及下运动神经元的疾病 ,如重症肌无力 ,或医源性因素 ,如颈部放疗等。 PES松弛不足将导致 U ES失弛张症 ,常由于舌骨上肌群疾病引起 ,表现为舌运动障碍或咽肌收缩无力。如果严格掌握适应证 ,外科手术切开 UES可获得比较满意的效果。

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • 卒中后吞咽障碍者早期康复护理

    【摘要】 目的 观察早期康复护理对卒中后吞咽障碍患者的临床疗效影响。方法 2006年1月—2008年12月,65例脑卒中合并吞咽障碍患者接受了早期康复专项护理(包括刺激咽部,练习屏气和发音,唇、舌、颊部力量训练,吸吮训练和喉抬高训练等),67例同期住院仅接受常规康复护理同病患者为对照组。两组患者干预前后接受日本康复医学会编制的“吞咽困难评估量表”评分和日常生活能力评估。结果 两组患者治疗前吞咽障碍评分接近,治疗后均明显高于治疗前,同时专项护理组治疗后评分也明显高于对照组(Plt;0.05)。专项护理组吞咽障碍症状基本痊愈16例(24.62%),好转21例(32.31%),有效18例(27.69%),无效10例(15.38%),总有效率为84.62%,明显优于对照组(68.65%)(Plt;0.01)。结论 早期康复护理可明显改善卒中后吞咽障碍患者的临床疗效。

    Release date:2016-09-08 09:37 Export PDF Favorites Scan
  • Therapeutic Effect of Medium Frequency ElectroStimulant Therapy for Dysphagia in Stroke Patients

    目的:观察中频电刺激治疗急性缺血性脑卒中后吞咽困难的临床疗效。方法:选取急性缺血性脑卒中并发生吞咽困难的患者80例,随机分为治疗组和对照组,两组临床用药完全一致,对照组和治疗组分别辅以冰刺激和中频电刺激进行康复治疗,疗程为1月。观察患者吞咽困难的恢复情况.结果:治疗组治愈率为35%,总有效率为90%,与对照组比较差异具显著性。结论:中频电刺激是治疗脑卒中后吞咽困难的一种有效、简便、安全的方法,可推荐临床使用。

    Release date:2016-09-08 10:01 Export PDF Favorites Scan
  • A clinical study on facial palsy after stroke

    Objective To investigate the clinical characteristics of facial palsy after stroke (FPS) in order to enhance the understanding of FPS. Methods Patients with stroke and admitted to hospital from March to June 2015 were selected in this study. They were evaluated by Modified House-Braekmann (MHBN), Barthel Index (BI), National Institute of Health Stroke Scale (NIHSS), Standardized Swallowing Assessment and Patient Health Questionnaire-9 (PHQ-9) within 48 hours after admitting. According to the MHBN scores, the patients were divided into FPS group and non-FPS group, and the incidences of dysphagia and depression, and the scores of BI, NIHSS, and PHQ-9 were compared between the two group. Six months later, the patients’ prognosis of stroke was assessed by the Modified Rankin Scale. Results A total of 129 patients were enrolled in this study, including 81 (62.8%) with FPS, and 48 (37.2%) without FPS. The incidences of dysphagia and depression in the FPS group (64.2%, 59.3%) were higher than those in the non-FPS group (22.9%, 18.8%), and the differences were statistically significant (P<0.05). The BI, NIHSS, PHQ-9 scores in the FPS group were 41.79±14.19, 11.23±4.62, 11.54±3.43, respectively, while the scores in the non-FPS group were 66.39±19.96, 7.54±3.69, 7.67±2.89, respectively; the differences in the scores between the two groups were statistically significant (P<0.05). Six months later, the patients’ prognosis in the non-FPS group was better than that in the FPS group (67.4%vs. 32.9%, P<0.001). Conclusions There is a high incidence of FPS, and there are high incidences of dysphagia and depression in the FPS patients with stroke. FPS influences the patients’ prognosis, so the understanding and treatment of FPS should be enhanced.

    Release date:2017-12-25 06:02 Export PDF Favorites Scan
  • Effects of digastric muscle low frequency modulated medium frequency electroacupuncture therapy and voice training for dysphagia in patients with aortic arch surgery: A randomized controlled trial

    Objective To investigate the combined effects of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training for dysphagia in patients who underwent aortic arch surgery. Methods Forty-two consecutive patients with dysphagia after aortic arch surgery between October 2014 and November 2017 were divided into two groups including an observation group and a control group. There were 21 patients in each group. There were 17 males and 4 females at age of 51.0±6.5 years in the observation group, while 18 males and 3 females at age of 49.8±7.3 years in the control group. The patients in the observation group underwent electroacupuncture therapy and voice training (20 min per day for each therapy, 2 weeks), while the patients in the control group only received safe swallowing education and rehabilitation guidance (2 weeks). The test results, such as fibrolaryngoscope and functional oral intake scale (FOIS) score, and the data of computer phonatory detection, before and after the intervention were compared. Results The fibrolaryngoscope of vocal cords significantly decreased and the FOIS score significantly increased after digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training in the observation group(6.30 vs. 4.60, P<0.05). Bucking was obviously reduced. The indicators of hoarse degree, such as median pitch, fundamental frequency, jitter (0.60%±0.96%vs. 1.99%±1.86%, P=0.033), shimmer (2.47%±4.26% vs. 5.89%±3.66%, P=0.043), maximum phonation time (15.31±9.10 s vs. 3.72±8.83 s, P=0.006), maximum and loud phonation time (9.30±5.73 s vs. 2.32±2.99 s, P=0.039), mean noise-to-harmonics ratio (23.99±10.17 vs .9.98±9.37, P=0.006) and mean harmonics-to-noise ratio (0.03±0.02 vs. 0.17±0.23, P=0.019) improved after the treatment in both groups. But the improvement in the observation group was significantly better than that in the control group. Conclusion The combination of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training on dysphagia in patients who underwent aortic arch surgery can significantly improve the swallowing function of patients. Meanwhile, it also helps the recovery of phonic function and improves the ability of feeding and communication in these patients.

    Release date:2018-06-01 07:11 Export PDF Favorites Scan
  • China expert consensus on home nutrition administration for elderly patients with dysphagia (version 2018)

    Release date:2018-06-20 02:05 Export PDF Favorites Scan
  • Systematic evaluation and meta-analysis of the effect of acupuncture combined with rehabilitation training on dysphagia after stroke

    ObjectiveTo systematically evaluate the effectiveness of acupuncture combined with rehabilitation training compared with simple rehabilitation training or acupuncture treatment of dysphagia after stroke, and make clear whether the effect of acupuncture combined with rehabilitation training is better than simple rehabilitation training or acupuncture treatment.MethodsSix databases including China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP, PubMed, Cochrance Library, and Embase were searched by computer for the randomized controlled trials on acupuncture combined with rehabilitation training treatment of post-stroke dysphagia, which were published from January 1st, 2010 to December 31st, 2018. After literature including, excluding, and screening, RevMan 5.3 software was used to conduct a meta-analysis.ResultsA total of 22 studies were included, including 1 987 patients. All the included studies took simple rehabilitation training or rehabilitation training combined with sham acupuncture as the control. Meta-analysis of efficiency and outcome measures for relevant studies showed that: compared with simple rehabilitation training, the effectiveness of acupuncture combined with rehabilitation training on post-stroke dysphagia was higher [17 studies included; odds ratio=3.66, 95% confidence interval (CI) (2.66, 5.05), P<0.000 01], the video fluoroscopy swallowing study score of acupuncture combined with rehabilitation training after treatment was higher [8 studies included; mean difference (MD)=2.31, 95%CI (1.75, 2.87), P<0.000 01], and the StandardizedSwallowing Assessment score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=−3.20, 95%CI (−3.78, −2.61), P<0.000 01]; at the same time the Watian Drinking Water Test score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=−0.65, 95%CI (−0.91, −0.39), P<0.000 01].ConclusionsAcupuncture combined with rehabilitation training is effective in dysphagia after stroke, and the combined effect is better than simple rehabilitation training. However, due to the limitations of quality of included literature and sample size, the above results and conclusions still require high quality and large sample studies to testify.

    Release date:2019-05-23 04:49 Export PDF Favorites Scan
  • Clinical effect of occipito-cervical fusion and causes of postoperative dysphagia: a preliminary study

    Objective To explore the clinical effect of occipital-cervical fusion and its impact on cervical curvature, and preliminarily study the causes of postoperative dysphagia. Methods The data of 24 patients who underwent occipito-cervical fusion in the Fourth People’s Hospital of Zigong between January 2014 and December 2018 were retrospectively analyzed, including 13 males and 11 females, aged 33-82 years, with an average age of (58.3±13.3) years. Among them, there were 14 cases of atlas fractures, 6 cases of atlantoaxial fractures, 1 case of intraspinal canal space-occupying lesion, 2 cases of chronic atlantoaxial dislocation with spinal cord compression, and 1 case of instability caused by inflammatory diseases. Japanese Orthopedic Association (JOA) score and Visual Analogue Scale (VAS) score were used to evaluate neurological function and pain of patients preoperatively and postoperatively. Occipito-cervical angle (O-C2) and lower cervical angle (C2-C7) were measured to evaluate the preoperative and postoperative angle changes in patients. The causes of postoperative dysphagia were analyzed. Results All the 24 patients were followed up for 8-50 months (26.3 months on average). The mean JOA score increased from 11.6±1.5 before surgery to 15.4±1.2 at the last follow-up, and the mean VAS score decreased from 6.4±1.1 before surgery to 2.0±0.6 at the last follow-up; the differences between the two time points were statistically significant (P<0.001). The bone graft fusion rate was 95.8% (23/24). The mean O-C2 angle decreased from (16.5±7.6)° before surgery to (14.7±4.5)° at the last follow-up, with no statistical significance (P=0.395). The mean angle of C2-C7 increased from (9.4±5.5)° before surgery to (16.3±3.5)° at the last follow-up, and the difference was statistically significant (P<0.001). Two patients developed postoperative dysphagia, possibly due to fusion in a flexion position. Conclusion Occipito-cervical fusion has reliable efficacy in treating occipito-cervical instability, with a high fusion rate and a low incidence of complications, but it will change the physiological curvature of upper and lower cervical vertebra, and fusion in a flexion position may cause postoperative dysphagia.

    Release date:2019-09-06 03:51 Export PDF Favorites Scan
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