环咽肌功能障碍患者康复结局的影响因素

doi:10.3969/j.issn.1006-9771.2021.08.013

摘要/Abstract

摘要：

目的初步分析环咽肌功能障碍患者吞咽障碍康复治疗的预后因素。方法 2017年10月至2020年12月,北京博爱医院住院康复的环咽肌功能障碍患者16例行吞咽功能康复和球囊扩张;回病房后自行完成Shaker法训练,记录训练依从性。治疗前后,采用藤岛一郎摄食吞咽功能评定法进行评定,根据评定结果将患者分为有效和无效两组。记录患者年龄、文化程度、病程、疗程、依从性、球囊扩张方式、球囊扩张次数和球囊最大注水容量等因素。结果治疗后,患者吞咽评分显著提高(Z = -3.550, P < 0.001);两组间年龄(Z = 0.833, P = 0.031)和依从性(P = 0.003)有显著性差异。年龄与疗效呈负相关(r = -0.533, P = 0.033),依从性与疗效呈正相关(r = 0.856, P < 0.001)。结论患者年龄和对康复训练的依从性影响环咽肌功能障碍患者吞咽障碍的治疗效果,年轻、依从性好的患者治疗效果更好。

关键词: 吞咽障碍, 环咽肌功能障碍, 康复, 影响因素

Abstract:

Objective To analyze the factors related to rehabilitation outcome of dysphagia for patients with cricopharyngeal dysfunction. Methods From October, 2017 to December, 2020, 16 inpatients with cricopharyngeal dysfunction in Beijing Bo'ai Hospital accepted swallowing training and balloon dilatation. They also finished Shaker exercise out of treatment rooms, and the compliance was recorded. They were assessed with Ichiro Fujishima's Ingestion-Swallowing Function Rating Scale, and divided into effective and ineffective groups according to the result of assessment. The factors such as ages, education levels, courses of disease, time of treatment, compliance, balloon dilation modes, balloon dilation times and maximum water capacity of the balloon were recorded. Results The score of swallowing improved after treatment (Z = -3.550, P < 0.001). There were significant differences between groups in age (Z = 0.833, P = 0.031) and compliance (P = 0.003). Age negatively correlated with effect (r = -0.533, P = 0.033), and compliance positively correlated (r = 0.856, P < 0.001). Conclusion Age and compliance to rehabilitation relate to the outcome of dysphagia for patients with cricopharyngeal dysfunction. It is more effective in patients with good compliance and younger age.

Key words: dysphagia, cricopharyngeal dysfunction, rehabilitation, related factors

袁永学,张庆苏. 环咽肌功能障碍患者康复结局的影响因素[J]. 《中国康复理论与实践》, 2021, 27(8): 973-977.

YUAN Yong-xue,ZHANG Qing-su. Factors Related to Rehabilitation Outcome of Dysphagia for Patients with Cricopharyngeal Dysfunction[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(8): 973-977.

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自变量		无效(n = 4)	有效(n = 12)	D值	P值
年龄(岁)		63(61.25, 66.25)	56(48.75, 57.75)	0.83	0.031
病程(d)		22.5(20, 28)	21.25(18.2, 46.5)	0.42	0.675
疗程(d)		41(17.25, 66.25)	45(26.25, 62)	0.25	0.952
扩张次数		19(11.25, 26.75)	14.5(11, 21.75)	0.33	0.859
球囊最大注水量(ml)		5.75(4.37, 6)	6(5, 6)	0.25	0.991
文化程度(n)	初/高中	3	5	–	0.285
文化程度(n)	大专/大学	1	7	–	0.285
依从性(n)	差	4	1	–	0.003
依从性(n)	好	0	11	–	0.003
扩张方式(n)	经鼻	3	4	–	0.192
扩张方式(n)	经口	1	8	–	0.192

自变量	r值	P值
年龄	-0.533	0.033
病程	0.298	0.262
疗程	0.016	0.954
扩张次数	-0.157	0.561
球囊最大注水容量	0.148	0.583
文化程度	0.298	0.278
依从性	0.856	< 0.001
扩张方式	0.364	0.166

自变量	r值	P值
依从性	0.313	0.237
疗程	-0.196	0.466