Research progress on rehabilitation assessment and treatment of dysphagia after stroke
NIU Li1 LI Yanjie2 QIN Hewei2 LU Yongbao1 SUN Yubin3 LI Sijin1
1.School of Rehabilitation Medicine, He′nan University of Chinese Medicine, He′nan Province, Zhengzhou 450046, China;
2.Department of Rehabilitation Medicine, He′nan Province Hospital of Traditional Chinese Medicine, He′nan Province, Zhengzhou 450002, China;
3.the Second Clinical Medical College, He′nan University of Chinese Medicine, He′nan Province, Zhengzhou 450046, China
Abstract:Dysphagia is a common complication of cerebral apoplexy. During the course of the disease, it is easy to cause aspiration pneumonia, recurrent cough and asphyxia, even life-threatening. This paper reviews the progress of bedside screening, instrument evaluation and rehabilitation for patients with dysphagia after stroke. Understanding the methods, advantages and disadvantages and application scope of commonly used swallowing assessment tools is very important to identify the causes of swallowing disorders and determine the degree of dysphagia in patients. It also provides scientific guidance for clinical rehabilitation treatment. The treatment of dysphagia in stroke includes oropharyngeal muscle movement sensory training, feeding training, airway protection, neuromuscular electrical stimulation, intermittent oral feeding, balloon catheter dilatation. The aim is to improve the swallowing function and reduce the complications, so as to provide a theoretical basis for clinical rehabilitation therapy to treat the dysphagia after stroke.
牛丽1 李彦杰2 秦合伟2 卢永保1 孙钰斌3 李斯锦1. 脑卒中后吞咽障碍康复评估和治疗研究进展[J]. 中国医药导报, 2020, 17(28): 48-51,63.
NIU Li1 LI Yanjie2 QIN Hewei2 LU Yongbao1 SUN Yubin3 LI Sijin1. Research progress on rehabilitation assessment and treatment of dysphagia after stroke. 中国医药导报, 2020, 17(28): 48-51,63.
[1] Johnson W,Onuma O,Owolabi M,et al. Stroke:a global response is needed [J]. Bull World Health Organ,2016,94(9):634.
[2] 王陇德,刘建民,杨弋,等.我国脑卒中防治仍面临巨大挑战—《中国脑卒中防治报告2018》概要[J].中国循环杂志,2019,34(2):105-119.
[3] Takizawa C,Gemmell E,Kenworthy J,et al. A systematic review of the prevalence of oropharyngeal dysphagia in stroke,Parkinson′s disease,Alzheimer′s disease,head injury,and pneumonia [J]. Dysphagia,2016,31(3):434-441.
[4] 陈央微,徐洛丹.早期鼻饲介入对脑卒中吞咽障碍并发肺部感染的影响[J].吉林医学,2014,35(15):3357.
[5] 武文娟,毕霞,宋磊,等.洼田饮水试验在急性脑卒中后吞咽障碍患者中的应用价值[J].上海交通大学学报:医学版,2016,36(7):1049-1053.
[6] 温水群,邓振兴,徐秋萍,等.改良洼田饮水试验在脑卒中吞咽障碍患者中的研究应用[J].中国当代医药,2018, 25(16):47-49.
[7] 张惠利,朱立春,薛秀娟,等.改良洼田饮水试验评价中风后吞咽困难的临床研究[J].医药前沿,2014(23):108.
[8] 王如蜜,兰纯娜,张长杰,等.EAT-10中文版在急性期脑卒中患者口咽期吞咽障碍筛查中的敏感度及特异度评价[J].中华物理医学与康复杂志,2017,39(6):422-426.
[9] Cheney DM,Siddiqui MT,Litts JK,et al. The ability of the 10-item eating assessment tool (EAT-10) to predict aspiration risk in persons with dysphagia [J]. Ann Otol Rhinol Laryngol,2015,124(5):351-354.
[10] Jiang JL,Yu JL,Wang JH,et al. Evaluation of the Chinese version of the swallowing screen in stroke patients with dysphagia [J]. Ci Ji Yi Xue Za Zhi,2019,31(4):270-275.
[11] Andrade JS,Souza WWOJ,Paranhos LR,et al. Effects of speech therapy in hospitalized patients with post-stroke dysphagia:a systematic review of observational studies [J]. Acta Med Port,2017,30(12):870-881.
[12] Kim YK,Cha JH,Lee KY. Comparison of dysphagia between infratentorial and supratentorial stroke patients [J]. Ann Rehabil Med,2019,43(2):149-155.
[13] 姚晓明,徐秀林.吞咽功能评估技术研究进展[J].中华物理医学与康复杂志,2017,39(1):73-75.
[14] 窦祖林,温红梅,戴萌,等.第七届欧洲吞咽障碍年会暨首届世界吞咽障碍论坛纪实[J].中华物理医学与康复杂志,2017,39(12):957-960.
[15] 庄任,方罡,贺颖超,等.表面肌电图技术在脑卒中后吞咽障碍评估中的应用[J].中国临床研究,2019,32(4):493-496.
[16] 韩婕,阎文静,戴玲莉,等.表面肌电图在脑卒中吞咽障碍患者康复疗效评估中的应用研究[J].中国康复医学杂志,2013,28(6):579-581.
[17] Park HS,Park JY,Kwon YH,et al. Effect of orbicularis oris muscle training on muscle strength and lip closure function in patients with stroke and swallowing disorder [J]. J Phys Ther Sci,2018,30(11):1355-1356.
[18] 王珊珊,顾莹,刘敏,等.口肌生物反馈训练结合常规吞咽康复训练治疗脑卒中后吞咽障碍的疗效观察[J].中华物理医学与康复杂志,2017,39(1):27-29.
[19] Li W,Kang X,Ren JL,et al. Effects of extended in-patient treatment training on outcome of post-stroke dysphagia [J]. Eur Rev Med Pharmacol Sci,2017,21(24):5711-5716.
[20] 杨峰,李坤颖,王茉莉,等.自制薄荷冰棒冷热交替刺激辅助治疗脑卒中患者吞咽障碍[J].护理学杂志,2016, 31(15):73-75.
[21] Jang HJ,Leigh JH,Seo HG,et al. Effortful swallow enhances vertical hyolaryngeal movement and prolongs duration after maximal excursion [J]. J Oral Rehabil,2015, 42(10):765-773.
[22] 李士林,孙伟铭,赵娜,等.门德尔松吞咽法改善吞咽障碍的研究现状[J].中国康复理论与实践,2019,25(7):774-777.
[23] 王俏俏.吞咽训练在脑卒中后吞咽障碍中的应用效果分析[J].实用临床护理学电子杂志,2019,4(3):118.
[24] Lee KW,Kim SB,Lee JH,et al. Effects of neuromuscular electrical stimulation for masseter muscle on oral dysfunction after stroke [J]. Ann Rehabil Med,2019,43(1):11-18.
[25] Konecny P,Elfmark M. Electrical stimulation of hyoid muscles in post-stroke dysphagia [J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub,2018,162(1):40-42.
[26] 陈念,李新,宫璞,等.间歇经口管饲对伴延髓麻痹或假性延髓麻痹的急性卒中患者吞咽困难的影响[J].国际脑血管病杂志,2019,27(3):187-192.
[27] 张秋,王玉龙,方锐,等.脑卒中吞咽障碍患者早期行经皮内镜下胃造瘘术对康复效果的影响分析[J].中国康复,2019,34(9):461-464.
[28] 兰月,徐光青,窦祖林,等.改良球囊扩张术对脑干卒中后吞咽障碍患者食管上括约肌功能的影响[J].中华医学杂志,2013,93(33):2631-2636.
[29] 卫小梅,戴萌,王玉珏,等.改良球囊扩张治疗对脑干卒中后吞咽障碍患者皮质脑干束兴奋性的影响[J].中华物理医学与康复杂志,2017,39(12):893-898.
[30] 廖明霞,刘云诗,窦祖林,等.经口与经鼻导尿管球囊扩张术治疗脑干卒中后环咽肌失弛缓症的影响[J].中华物理医学与康复杂志,2017,39(4):279-282.