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目的:探讨早期吞咽训练对脑卒中后抑郁(PSD)的影响。方法:选取2013年1月至2015年12月中山市黄圃人民医院收治的急性脑卒中并吞咽障碍患者180例,以随机数字表法均分为观察组与对照组,各90例。观察组患者给予吞咽功能专业康复训练,对照组给予急性脑卒中常规治疗护理。随访6个月,观察两组患者吞咽障碍、PSD治疗效果。结果:脑卒中后吞咽障碍仅10.6%为重度病例,多数为轻中度患者(轻度:43.3%,中度46.1%);吞咽训练7 d、14 d后观察组的总有效率分别为94.4%、95.6%,明显高于对照组的58.9%和65.6%,组间比较,差异具有统计学意义(P<0.05);两组患者住院7 d焦虑、抑郁发生率比较,差异均无统计学意义(P>0.05);住院14 d后及随访3月、6月观察组患者抑郁发生率明显低于对照组,组间比较,差异具有统计学意义(P<0.05),同时PSD治疗效果也提高。结论:脑卒中超早期进行吞咽评估、诊断、治疗可促进吞咽障碍恢复,同时吞咽障碍与PSD发病率的疗效密切相关,吞咽功能恢复可降低PSD发病率。
Objective: To investigate the effect of early swallowing training on post-stroke depression (PSD). Methods: From January 2013 to December 2015, 180 cases of acute stroke and swallowing disorder admitted to Zhongshan Huangpu People’s Hospital were randomly divided into observation group and control group with 90 cases in each group. Patients in the observation group were given professional rehabilitation training of swallowing function, and the control group was given routine care and treatment of acute stroke. After 6 months of follow-up, two groups of patients with dysphagia and PSD were observed. Results: Only 10.6% of swallowing disorders after stroke were severe cases, most of whom were mild to moderate (mild: 43.3%, moderate 46.1%). After swallowing training for 7 days, the total effective rate of observation group after 14 days was 94.4 %, 95.6%, respectively, which were significantly higher than those in control group (58.9% and 65.6% respectively). There was significant difference between the two groups (P <0.05). There was no significant difference in anxiety and depression between the two groups (P> 0.05). The incidence of depression in the observation group was significantly lower than that in the control group after 14 days of hospitalization and follow-up in March and June, and the difference was statistically significant (P <0.05) improve. Conclusion: The evaluation of early swallowing stroke, diagnosis and treatment can promote the recovery of swallowing disorder. At the same time, the swallowing disorder is closely related to the effect of PSD, and the recovery of swallowing function can reduce the incidence of PSD.