论著

综合康复训练对脑卒中后轻度认知障碍患者的应用效果及认知功能影响

The application effect and cognitive function impact of comprehensive rehabilitation training on patients with mild cognitive impairment after stroke

:1080-1086
 
     目的   探讨综合康复训练对脑卒中后轻度认知障碍患者的应用效果及认知功能影响。方法   选取2022年2月—2023年2月暨南大学附属广州红十字会医院收治的80例脑卒中后轻度认知障碍患者展开前瞻性研究,应用抽签法将其分为综合康复组与常规组,各40例。常规组实施常规干预,综合康复组在常规组基础上增加综合康复训练,对比其认知功能,简易智能精神状态检查量表(MMSE)、美国国立卫生院卒中量表(NIHSS)评分变化,运动功能与平衡功能,日常生活能力与生活质量。结果   干预后综合康复组患者洛文斯顿作业疗法认知量表评分注意力为(3.36±0.42)分、思维运动为(17.34±2.31)分、定向力为(13.19±1.24)分,均高于常规组,且两组干预后高于干预前(P<0.05);干预后综合康复组患者MMSE评分为(25.58±4.12)分高于常规组,且两组干预后高于干预前,NIHSS评分为(14.53±2.62)分,低于常规组,且两组干预后低于干预前(P<0.05);干预后综合康复组患者Fugl-Meyer运动功能评定量表评分为(14.51±3.23)分、手臂动作调查测试表评分为(26.86±5.25)分、平衡量表评分为(43.06±5.13)分,高于常规组,且两组干预后高于干预前(P<0.05);干预后综合康复组患者日常生活活动能力量表评分为(53.02±4.43)分、脑卒中专用生活质量量表评分为(97.11±12.23)分,高于常规组,且两组干预后高于干预前(P<0.05)。结论   针对脑卒中后轻度认知障碍患者采取综合康复训练可促进患者认知功能恢复,提升患者运动功能及机体平衡功能,改善患者智力水平与神经功能,进一步提升患者日常生活能力与生活质量。
        Objective  To explore the effect of comprehensive  rehabilitation training on cognitive function in patients with mild cognitive impairment after stroke.Methods  A  prospective  study was conducted on  80  patients with mild cognitive impairment after stroke,who admitted to the hospital from February 2022 to February 2023.They were divided into a comprehensive rehabilitation group and a control group using a lottery method,with 40 patients in each group.The control group  received  routine intervention,while the comprehensive  rehabilitation group  received additional comprehensive  rehabilitation training on the basis of the control group.Their cognitive function,Mini Mental State Examination Scale(MMSE),National  Institutes of Health Stroke Scale in the United States(NIHSS)score changes,motor function and balance function,daily living ability and quality of life were compared.Results  After intervention,the Lowenstein Occupational Therapy Cognitive Scale scores of attention(3.36±0.42),thinking and motor(17.34±2.31),and orientation(13.19±1.24)in the comprehensive  rehabilitation group were higher than those in the control group,and both groups had higher scores after intervention than before(P<0.05).After intervention,the MMSE score(25.58±4.12)of patients in the comprehensive rehabilitation group was higher than that of the control group,and both groups had higher scores after intervention compared to those before intervention.The NIHSS score(14.53±2.62)was lower than that of the control group,and both groups had lower scores after intervention compared to those before interventionP<0.05).After intervention,the Fugl Meyer Assessment score(14.51±3.23),Arm Movement Survey Test Form score(26.86±5.25),and Balance Scale score(43.06±5.13)in the comprehensive rehabilitation group were higher than those in the control group,and both groups had higher scores after intervention than before(P<0.05).After intervention,the Basic Activity of Daily Living score(53.02±4.43)and stroke specific quality of life score(97.11±12.23)in the comprehensive  rehabilitation group were higher than those in the control group,and both groups had higher scores after intervention than before(P<0.05).Conclusions  Comprehensive  rehabilitation training for patients with mild cognitive impairment after stroke can promote cognitive function recovery,improve motor function and balance function,enhance intelligence and neurological function,and further improve daily living ability and quality of life.
论著

功能性经口摄食分级的吞咽管理对高龄吞咽障碍患者的应用效果

Application effect of Functional Oral Intake Scale swallowing management on elderly patients with swallowing disorders

:775-781
 
       目的  探讨功能性经口摄食分级的吞咽管理对高龄吞咽障碍患者的应用效果。方法  选取2022年5月—2024年5月暨南大学附属广州市红十字会医院收治的80例高龄吞咽障碍患者作为研究对象,应用随机数字表法将其分为观察组与对照组,各40例。对照组患者实施常规干预,观察组实施功能性经口摄食分级的吞咽管理干预,对比两组患者干预效果、干预前后的吞咽功能与营养状况、吞咽障碍相关并发症发生率,以及干预前后两组生活质量变化。结果  观察组总有效率为92.50%,高于对照组的72.50%(χ 2 =5.541,P=0.019);两组干预后综合性营养评估法(SGA)、进食评估问卷调查工具-10(EAT-10)评分均降低,且观察组[(6.62±1.24)(15.26±3.42)分]低于对照组[(10.85±2.32)(23.51±4.37)分],对比差异有统计学意义(t分别为10.170、9.403,P<0.05);观察组吞咽障碍相关并发症发生率17.50%低于对照组42.50%(χ 2 =5.952,P=0.015);两组干预后生活质量综合评定量表(GQOLI-74)相关维度物质评分均升高,且观察组患者GQOLI-74相关维度物质生活(16.62±2.24)、心理功能(18.26±4.42)分、社会功能(21.62±3.66)分、躯体功能(23.26±4.37)分均高于对照组[(13.25±3.32)(13.51±2.37)(15.26±2.35)(16.62±3.73)]分,对比差异有统计学意义(t分别为5.322、5.990、9.248、7.309,P<0.05)。结论  功能性经口摄食分级的吞咽管理对高龄吞咽障碍患者干预效果显著,且可提升其吞咽功能,改善营养状况,同时可辅助降低吞咽障碍相关并发症发生率,提高患者生活质量。
       Objective  To explore the application effect of Functional Oral Intake Scale(FOIS)swallowing management on elderly patients with swallowing disorders.Methods  A total of 80 elderly patients with dysphagia admitted to the Guangzhou Red Cross Hospital Affiliated to Jinan University from May 2022 to May 2024 were selected as research subjects.They were divided into an observation group and a control group,with 40 cases in each group,using a random number table method.The control group received routine intervention,while the observation group received FOIS swallowing management intervention.The intervention effects were compared between the two groups,including pre and post intervention,swallowing function and nutritional status,incidence of swallowing related complications,and changes in quality of life before and after the intervention.Results  The total effective rate of the observation group was 92.50%,which was higher than the 72.50% of control group(χ 2 =5.541,P=0.019).After the intervention,the comprehensive nutrition assessment(SGA)and the feeding assessment instrument-10(EAT-10)were decreased,and the observation group ([6.62±1.24]and[15.26±3.42]) were lower than the control group ([10.85±2.32]and[23.51±4.37]),and the comparative difference was statistically significant(t=10.170,9.403,P<0.05).The incidence of complications related to swallowing disorders in the observation group was 17.50%,lower than that in the control group was 42.50%(χ 2 =5.952,P=0.015).After intervention,the scores of GQOLI-74 related dimensions were increased in both groups.In addition,GQOLI-74 related dimensions of material life(16.62±2.24)scores,psychological function(18.26±4.42)scores,social function(21.62±3.66)scores,physical function(23.26±4.37)scores in observation group were higher than those in control group ([13.25±3.32],[13.51±2.37],[15.26±2.35],[16.62±3.73]),and the difference was statistically significant(t=5.322,5.990,9.248,7.309,P<0.05).Conclusions  The swallowing management of FOIS has a significant intervention effect on elderly patients with swallowing disorders,and can improve their swallowing function,nutritional status,and assist in reducing the incidence of swallowing disorder related complications,thereby improving the quality of life of patients.
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