《中国康复理论与实践》

• 康复护理 • 上一篇    下一篇

针刺结合医护合作模式对卒中相关性肺炎的影响①

牛瑛琳,白艳杰,王晓丹,刘雁,王莉娜   

  1. 河南中医学院第一附属医院,河南郑州市450000。
  • 出版日期:2016-02-25 发布日期:2016-06-01

Effect of Acupuncture Combined with Doctor-nurse Cooperation Mode on Stroke-associated Pneumonia

NIU Ying-lin, BAI Yan-jie, WANG Xiao-dan, LIU Yan, WANG Li-na   

  1. Rehabilitation Research Centre of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan 450000, China
  • Published:2016-02-25 Online:2016-06-01

摘要: 目的研究针刺结合医护合作模式对急性脑卒中患者卒中相关性肺炎的影响。方法2013 年3 月~2015 年1 月本院病程1 周内的急性脑卒中患者67 例,随机分为对照组(n=35)和观察组(n=32)。两组均接受神经内科常规治疗,并在一般护理模式下由专业治疗师行系统康复训练;观察组额外接受医护合作模式下的针刺治疗。记录并分析两组患者卒中相关性肺炎发生率、吞咽功能改善情况及误吸率。结果治疗后,观察组卒中相关性肺炎发生率较对照组降低(χ2=4.615, P=0.032)。观察组会厌谷、梨状窝滞留量(t 稀钡=21.01, t 稠钡=19.85),咽期时长(t 稀钡=17.03, t 稠钡=13.68)及咽期起始时间(t 稀钡=19.63, t 稠钡=17.86)低于对照组(P<0.05)。稀钡实验中,观察组患者误吸率低于对照组(χ2=4.03, P=0.044),但在稠钡及固体实验中无显著性差异(P>0.05)。结论针刺结合医护合作模式可降低急性卒中患者误吸率及卒中相关性肺炎的发生率,可能与改善其吞咽功能有关。

关键词: 卒中相关性肺炎, 医护合作模式, 针刺, 吞咽

Abstract: Objective To investigate the efficacy of acupuncture combined with doctor- nurse cooperation mode on stroke- associated pneumonia in patients with acute stroke. Methods 67 patients of acute stroke within 1 week in our hospital from March, 2013 to January, 2015 were randomly divided into control group (n=35) and treatment group (n=32). Both groups received neurological routine treatment and systematic rehabilitation training by professional physiotherapists under general nursing mode. The treatment group received acupuncture treatment under doctor-nurse cooperation mode additionally. Incidence of stroke-associated pneumonia, swallow function and aspiration rate were recorded. Results Compared with the control group, the incidence of stroke-associated pneumonia significantly decreased in the treatment group after treatment (χ2=4.615, P=0.032). The retention volume of epiglottic vallecula and pyriform sinus (tdilute barium=21.01, tthick barium= 19.85), the duration of pharynx period (tdilute barium=17.03, tthick barium=13.68), and the start time of pharynx period (tdilute barium=19.63, tthick barium=17.86) were less in the treatment group than in the control group (P<0.05). In the test of dilute barium, the aspiration rate was lower in the treatment group than in the control group (χ2=4.03, P=0.044), however, there was no significant difference between 2 groups in the test of thick barium and solid food (P>0.05). Conclusion Acupuncture combined doctor-nurse cooperation mode may decrease the rates of aspiration and stroke-associated pneumonia in acute stroke patients through improving their swallow function.

Key words: stroke-associated pneumonia, doctor-nurse cooperation mode, acupuncture, swallow