目的：讨论间歇经口至食管管饲法（intermittent oro-esophageal tube feeding，IOE）配合个体化呼吸功能训练对脑卒中后所致的口腔、咽期吞咽功能障碍患者的临床疗效。

方法：选取脑卒中后口腔、咽期吞咽功能障碍患者 30 例，随机分为对照组和观察组（各15例）。在使用常规吞咽障碍方法治疗的基础上，观察组使用 IOE 联合个体化呼吸功能训练进行治疗，对照组使用 IOE 进行治疗，共治疗 2 周。在治疗前后，使用洼田饮水试验、吞咽造影检查对吞咽功能进行评估 ；测定用力肺活量、第 1 秒用力呼气容积及呼气流量峰值评价呼吸功能 ；使用吞咽生命质量量表对患者生活质量进行评估。治疗期间，观察患者发生误吸、肺炎和营养不良的情况。

结果：治疗前 2 组患者的吞咽功能、呼吸功能、吞咽生命质量的差异无统计学意义（P ＞0.05），治疗 2 周后，观察组的吞咽功能、呼吸功能、吞咽生命质量均明显优于对照组，差异均有统计学意义（P ＜0.05）。治疗2周后，观察组并发症发生率显著低于对照组（P ＜0.05）。

结论：对于脑卒中后口腔、咽期吞咽障碍的患者，在常规吞咽功能训练治疗基础上，应用IOE配合个体化呼吸功能训练，能明显促进患者吞咽功能恢复、改善呼吸功能、减少并发症、提高生活质量。

Objective:To discuss the effect of intermittent oro-esophageal tube feeding (IOE) combined with individualized respiratory function training in patients with oral and pharyngeal dysphagia after stroke.

Methods: Thirty patients with oral and pharyngeal dysphagia after stroke were randomly divided into observation group (15 cases) and control group (15 cases). Based on conventional treatment of dysphagia, the observation group was treated with IOE combined with individualized respiratory function training, and the control group was treated with IOE for 2 weeks. Before and after treatment, the swallowing function was evaluated by drinking water test and video fluoroscopic swallowing study. The respiratory function was evaluated by measuring forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF). A Swallowing Quality of Life scale was used to evaluate the quality of life. During the treatment, the complications such as aspiration, pneumonia and malnutrition were observed.

Results: There were no significant differences in swallowing function, respiratory function and swallowing quality of life between the 2 groups before treatment (P>0.05). After 2 weeks of treatment, the observation group was significantly better than the control group in the above three aspects (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05) after 2 weeks of treatment.

Conclusion: In the rehabilitation of patients with oral and pharyngeal dysphagia after stroke, on the basis of routine dysphagia therapy, IOE combined with individualized respiratory function training can obviously promote the recovery of swallowing function, improve respiratory function, reduce complications, and improve the quality of life.