冯丹枫

摘  要：目的  观察舌三针联合球囊扩张术治疗缺血性中风后假性球麻痹所致吞咽障碍的疗效。方法  择取广州市荔湾区中医医院针灸康复科于2018年9月～2019年8月期间收治的缺血性中风假性球麻痹吞咽障碍患者69例，采用随机数字表法分为两组，所有患者均给予常规对症治疗，将采用舌三针联合导尿管球囊扩张术治疗的35例患者作为治疗组，将使用吞咽治疗仪治疗的34例患者作为对照组，10次治疗为1个疗程，治疗2个疗程后将两组的疗效进行比较。结果  2个疗程后，治疗组吞咽障碍功能计分低于对照组，组间治疗后得分比较，差异具有统计学意义（P<0.05）。治疗组总有效率优于对照组，两组总有效率比较，差异具有统计学意义（P<0.05）。结论  舌三针联合球囊扩张术治疗缺血性中风后假性球麻痹吞咽障碍效果优于单纯使用吞咽治疗仪，值得临床应用。

关键词：缺血性中风;吞咽障碍;舌三针;球囊扩张术

中图分类号：R277.7    文献标识码：A    文章编号：1009-8011（2021）-3-0005-04

Abstract： Objective  To explore the efficacy of tongue three-pin combined balloon dilation to treat pseudo-globulity dysphagia after an ischemic stroke.Methods  Collect 69 cases of ischemic stroke pseudo-globulity dysphagia swallowing disorder admitted from September 2018 to August 2019 in the Acupuncture Rehabilitation Department of Guangzhou Liwan District Chinese Medicine Hospital， and all patients were given routine treatment in neurology.The patients were divided two group as random number table method. The 35 patients treated with three-pin joint catheter balloon expansion were treated as a treatment group， 34 patients treated with swallowing instrument sitptolic as a control group， 10 times for 1 course of treatment， and the efficacy of the two groups was compared after treatment of 2 courses. Results  After 2 courses of treatment， the two groups of swallowing disorder function score was compared， the treatment group scored the treatment group swallowing disorder function score was lower than that in the control group， the difference between the group after treatment was compared with Statistically significant（P<0.05） .  The total efficiency of the treatment group was better than that in the  control group， and the total efficiency of the two groups was statistically significant（P<0.05）.  Conclusion  It is better that the patient with pseudo-globulity swallowing disorder after ischemic stroke be given with  tongue tree-pin combined balloon dilation than which be treated by swallowing instrument sitptolic， which is worthy of clinical adoption.

Keywords： ischemic stroke; dysphagia; tongue three-shot; balloon dilatation

吞咽功能障礙是脑中风的常见并发症之一，其可引起误吸、吸入性肺炎以及营养不良，降低患者生存质量，缩短患者生存时间，因此，寻找更有效的治疗方法具有重要意义。针对脑卒中后吞咽障碍， 国外多使用吞咽康复训练方法，而国内更多地使用中西医综合治疗方法[1-2]。吞咽康复训练主要针对吞咽期功能障碍进行康复训练，对于吞咽准备期及口腔期疗效令人不满意;中药主要是针对病人整体的表现进行辩证治疗，对于咽部局部重视不足;而针灸疗法[3-4]主要是针对患者症状和体征进行辨证选穴治疗，但是对于病因的分辨不太重视，如：是缺血性中风抑或是出血性中风，还是缺血合并出血;是皮质/皮质下型，还是内囊型，拟或是脑桥型;是假性延髓麻痹拟或是真性延髓麻痹，在针灸疗法中都没有进行仔细区分[5]。……