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目的探讨强化呼吸训练对老年卒中伴吞咽障碍患者吞咽功能及肺功能的影响。方法收集2012年1月—2015年2月襄阳市中心医院康复医学科住院的老年卒中合并吞咽障碍患者70例,采用随机数字表法分为对照组(n=35)和实验组(n=35)。对照组进行吞咽功能康复训练,实验组进行吞咽功能康复训练基础上,同时进行强化呼吸训练,1次/d,6次/周,共治疗4周。于治疗前、治疗4周后采用洼田饮水试验分别对2组患者吞咽功能进行评定分级,同时测定用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及呼气峰值流速(PEF)评定肺功能。结果治疗后,2组患者的洼田饮水试验与组内治疗前比较,差异有统计学意义(P<0.05),且2组患者治疗有效率比较,差异有统计学意义(P<0.05);治疗后2组患者FVC、FEV1及PEF较治疗前均有一定程度的改善(P<0.05),且实验组改善程度较对照组显著,组间差异比较有统计学意义(P<0.05)。结论强化呼吸训练结合吞咽功能训练能明显改善老年卒中后吞咽障碍患者的呼吸功能,随着呼吸功能的改善,吞咽功能改善的有效率明显提高,且方法及操作简便可行,值得在临床进一步推广。
Objective To investigate the effects of intensive breathing training on swallowing function and pulmonary function in elderly stroke patients with swallowing disorders. Methods Seventy patients with senile stroke complicated with swallowing admitted to Department of Rehabilitation Medicine, Xiangyang Central Hospital from January 2012 to February 2015 were divided into control group (n = 35) and experimental group (n = 35) by random number table ). The control group was swallowing functional rehabilitation training, experimental group swallowing functional rehabilitation training, based on the same time, intensive breath training, 1 / d, 6 times / week for a total of 4 weeks. Before treatment and 4 weeks after treatment, the Kawada drinking water test was used to evaluate the swallowing function of the two groups. FVC, FEV1 and PEF were also measured. Assessment of lung function. Results After treatment, there was significant difference between the two groups in water drinking test and before treatment in the group (P <0.05), and the difference between the two groups was statistically significant (P <0.05). After treatment, the FVC, FEV1 and PEF in both groups were improved to a certain extent (P <0.05), and the improvement in the experimental group was more significant than that in the control group. The difference between the two groups was statistically significant (P <0.05). Conclusions Intensive respiration training combined with swallowing training can significantly improve the respiratory function of patients with swallowing disorders after stroke. As the respiratory function improves, the effective rate of swallowing improvement is obviously improved. The method and operation are simple and feasible, which is worth further promotion in clinic.