目的:探讨代偿性吞咽措施对脑卒中伴吞咽障碍患者吞功能的康复效果。

方法:60 例脑卒中伴吞咽障碍患者随机分为对照组(30 例)和研究组(30 例)。对照组患者在常规护理基础上进行口腔操训练，研究组在常规护理基础上进行口腔操训练联合代偿性吞咽措施。采用 Gugging 吞咽功能评估表(Gugging Swallowing Screen,GUSS)评估康复训练后吞咽功能的改善情况。

结果:康复训练 2周后,2 组患者的 GUSS 评分均显著提高,并且研究组患者的 GUSS 评分显著高于对照组(P<0.05):研究组患者吞咽功能的恢复亦优于对照组,差异有统计学意义P<0.05):研究组的流涎发生率低于对照组(33.33% vs 63.33%,P<0.05),误吸发生率也低于对照组(30.00% vs 60.00%,P<0.05)。

结论:代偿性吞咽措施有利于提高脑卒中伴吞咽障碍患者的口咽肌群力,促进吞咽功能的恢复,并且有助于减少流涎和肺部感染,提高鼻饲管拔管成功率,缩短留置胃管的时间。

Obiective: Explore the rehabilitation effect of compensatory swallowing measures on swallowing function in stroke patients with dysphagia.

Methods: Sixty stroke patients with dysphagia were randomly divided into a control group(30 cases) and a study group (30 cases). The control group received oral exercise training on the basis of routine care, while the study group received oral exercise training combined with compensatory swallowing measures training on the basis of routine care. The Gugging Swallowing Screen (GUSS)was used to evaluate the improvement of swallowing function after rehabilitation training.

Results: After 2 weeks of rehabilitation training, the GUSS scores of both groups of patients were significantly improved, and the GUSS scores of the study group were significantly higher than those of the control group (P<0.05). The recovery of swallowingfunction in the study group was better than that in the control group, with a statistically significant diference (P<0.05). The incidence of salivation in the study group was lowel than that in the control group (33.33%vs 63.33%,P<0.05], and the incidence of aspiration was also lower than that in the control group (30.00% vs 60.00%, P<0.05).

Conclusion: Compensatory swallowing measures are beneficial for improving the strength of the oropharyngeal muscles in stroke patients with dysphagia, promoting the recovery of swallowing function, reducing salivation and lung infections, improving the success rate of gastric tube removal, and shortening the time for indwelling gastric tubes.