床旁吞咽治疗对ICU的脑卒中伴意识障碍患者吞咽功能及意识状态的疗效观察

关键词：ICU  脑卒中  意识障碍  床旁吞咽治疗  2min自发吞咽频率  简易吞咽激发测试

Keywords:ICU  stroke  disturbance of consciousness  bedside swallowing therapy  the 2-minute frequency of spontaneous swallowing  simple swallowing provocation test

摘要：

      摘要 目的：探讨床旁吞咽治疗对在ICU的脑卒中伴意识障碍患者吞咽功能及意识状态的疗效。 方法：2021年6月—2023年9月，ICU的脑卒中伴意识障碍患者60例随机分成对照组（n=30）和观察组（n=30），对照组采用ICU临床治疗，观察组在ICU临床治疗基础上增加床旁吞咽治疗，共治疗4周。治疗前后对患者吞咽功能及意识状态进行评定。 结果：治疗后，观察组2min自发吞咽频率（1.17±0.99）次，高于对照组（0.67±0.84）次，差异有显著性意义（P<0.05）；治疗后，观察组简易吞咽激发测试第一步和第二步阳性率分别为66.7%和43.3%，均低于对照组80%和56.7%，且观察组简易吞咽激发测试第二步阳性率治疗后显著低于治疗前，差异有显著性意义（P<0.05）；治疗后，观察组标准吞咽功能评价量表评分显著低于对照组评分，差异有显著性意义（P<0.05）。治疗后，观察组格拉斯哥昏迷量表评分显著高于对照组评分，差异有显著性意义（P<0.05）。 结论：床旁吞咽治疗对在ICU的脑卒中伴意识障碍患者吞咽功能及意识状态均具有改善作用。

Abstract:

      Abstract Objective：To investigate the effect of bedside swallowing therapy on swallowing function and conscious status of stroke patients with disturbance of consciousness in ICU. Method：From June 2021 to September 2023， 60 patients with stroke and disturbance of consciousness in ICU were randomly divided into control group （n=30） and observation group （n=30）. The control group received clinical treatment in ICU， and the observation group was treated with bedside swallowing therapy on the basis of clinical treatment in ICU for a total of 4 weeks. Swallowing function and state of consciousness were evaluated before and after treatment. Result：After treatment， the 2-minute frequency of spontaneous swallowing in the observation group was （1.17±0.99） times， which was higher than that in the control group （0.67±0.84） times， and the difference was statistically significant （P<0.05）. After treatment， the positive rate of the first and second steps of simple swallowing provocation test in the observation group was 66.7% and 43.3%， respectively， both lower than that of the control group 80% and 56.7%， and the positive rate of the second step of simple swallowing provocation test in the observation group was significantly lower after treatment than before treatment， with statistical significance（P<0.05）. After treatment， standardized swallowing assessment score of the observation group was significantly lower than that of the control group， and the difference was statistically significant （P<0.05）. After treatment， the score of glasgow coma scale in the observation group was significantly higher than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion：Bedside swallowing therapy can improve the swallowing function and conscious state of stroke patients with disturbance of consciousness in ICU.