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目的:探讨冷热交替刺激口咽部加颈项按摩在脑梗死假性延髓性麻痹中的应用效果。方法 :选取2016年5~10月广州市中医医院和广州市惠爱医院脑梗死后假性延髓性麻痹的住院患者60例为研究对象,按入院顺序以随机数字表法将患者等分为对照组与观察组,对照组采用常规治疗及护理方法;观察组在对照组的基础上给予冷热交替刺激口咽部加颈项按摩,于干预前后采用洼田饮水试验评价吞咽功能的变化,采用脑卒中量表评价神经功能的变化,比较两组吸入性肺炎的发生率。结果:观察组干预后的洼田饮水试验评分低于对照组,吞咽功能改善有效率高于对照组,差异有统计学意义(P<0.05)。观察组干预后的神经功能缺损评分低于对照组,吸入性肺炎的发生率低于对照组,差异有统计学意义(P<0.05)。结论:冷热交替刺激口咽部加颈项按摩能够改善脑梗死后假性延髓性麻痹患者的吞咽功能和神经功能,减少吸入性肺炎的发生。
Objective: To explore the effect of alternating hot and cold stimulation of oropharyngeal neck massage in pseudobulbar paralysis of cerebral infarction. Methods: Sixty inpatients with pseudo-bulbar paralysis after cerebral infarction in Guangzhou TCM Hospital and Guangzhou Hui-Ai Hospital from May to October in 2016 were selected as research objects. Patients were randomly divided into control group The observation group and the control group were given routine treatment and nursing. The observation group was given hot and cold alternately on the basis of the control group to stimulate the oropharyngeal and neck massage. The changes of swallowing function were evaluated by the Kubota drinking water test before and after the intervention. Stroke scale evaluation of neurological changes, compared the incidence of aspiration pneumonia in both groups. Results: The Kubota drinking water test score of the observation group was lower than that of the control group, and the swallowing function improved and the effective rate was higher than that of the control group (P <0.05). The score of neurological deficit in the observation group was lower than that of the control group, and the incidence of aspiration pneumonia was lower than that of the control group (P <0.05). CONCLUSION: Alternating cold or hot stimulation of oropharynx with cervical massage can improve the swallowing function and nerve function of pseudo-bulbar paralysis patients after cerebral infarction and reduce the occurrence of aspiration pneumonia.