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中国人民解放军总医院老年心血管病研究所
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
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王多多,郭洁,全玉丽,陈兰兰.门德尔松手法及摄食训练对老年帕金森病合并吞咽功能障碍患者的影响[J].中华老年多器官疾病杂志,2019,18(9):646~650
门德尔松手法及摄食训练对老年帕金森病合并吞咽功能障碍患者的影响
Effects of Mendelssohn′s techniques and feeding training on swallowing function in the elderly with Parkinson′s disease
投稿时间:2019-04-14  
DOI:10.11915/j.issn.1671-5403.2019.09.140
中文关键词:  吞咽障碍;帕金森病;舒适度;门德尔松手法;摄食训练
英文关键词:dysphagia; Parkinson disease; comfortableness; Mendelssohn′s techniques; feeding training
基金项目:无锡市科技发展指导性计划项目(CSZ0N1616)
作者单位E-mail
王多多 解放军联勤保障部队第90 4 医院 神经内科,无锡 214000  
郭洁 解放军联勤保障部队第90 4 医院康复科,无锡 214000  
全玉丽 无锡市滨湖区中医院急诊科,无锡 214000  
陈兰兰 无锡市精神卫生中心神经康复科,无锡 214000 2586897055@qq.com 
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中文摘要:
      目的 探究门德尔松手法及摄食训练对老年帕金森病合并吞咽功能障碍患者的治疗效果。方法 选取2016年1月至2018年月2解放军联勤保障部队第904医院神经内科收治的老年帕金森病合并吞咽功能障碍患者104例,根据治疗方法不同将患者分为常规干预组52例(对照组)及门德尔松手法及摄食训练组52例(观察组)。对比2组患者干预前后吞咽功能障碍和舒适度改善情况,干预过程中吸入性肺炎、流涎发生率及干预后帕金森病严重程度。采用SPSS 18.0软件对数据进行统计分析。结果 干预后观察组患者吞咽功能障碍Ⅱ、Ⅲ、Ⅳ级分别占53.85%(28例)、32.69%(17例)及13.46%(7例),对照组比例依次为32.69%(17例)、36.54%(19例)及30.77%(16例),与对照组比较,观察组患者吞咽功能障碍显著改善,差异有统计学意义(χ2=2.479,P=0.013)。干预后观察组患者舒适度Ⅰ、Ⅱ、Ⅲ、Ⅳ级分别占42.31%(22例)、28.85%(15例)、23.08%(12例)及5.77%(3例),优于对照组的21.15%(11例)、23.08%(12例)、34.62%(18例)及21.15%(11例),差异有统计学意义(χ2=3.057,P=0.002)。与对照组比较,观察组吸入性肺炎[5.77%(3例)和25.00%(13例),χ2=5.983,P=0.005]、流涎[7.69%(4例)和28.85%(15例),χ2=7.792,P=0.000]发生率显著降低,差异有统计学意义。干预后观察组患者帕金森病严重程度1.0、1.5、2.0、2.5、3.0、4.0期分别有22、23、4、2、1及0例,对照组依次为12、25、8、4、2、1例,2组比较差异有统计学意义(χ2=2.432,P=0.015)。结论 门德尔松手法及摄食训练应用于老年帕金森病合并吞咽功能障碍患者有利于改善吞咽功能,降低吸入性肺炎、流涎发生率,提高患者舒适度,值得推广。
英文摘要:
      Objective To investigate the effects of Mendelssohn′s techniques and feeding training on swallowing function in the elderly Parkinson′s disease patients with dysphagia. Methods A total of 104 elderly Parkinson′s disease patients with dysphagia admitted in No. 904 Hospital from January 2016 to February 2018 were enrolled in this study. According to treatment methods, they were divided into routine intervention group (control group, n=52) and Mendelssohn′s techniques and feeding training group (observation group, n=52). Their swallowing dysfunction and comfortableness were observed and compared before and after intervention, and the incidences of aspiration pneumonia and salivation and the severity of Parkinson′s disease after intervention were compared between the 2 groups. SPSS statistics 18.0 was used to analyze the data. Results After intervention, the proportions of dysphagia grade Ⅱ, Ⅲ and Ⅳ were 53.85% (28 cases), 32.69%(17 cases) and 13.46%(7 cases) respectively in the patients of the observation group, while were 32.69%(17 cases), 36.54%(19 cases) and 30.77%(16 cases) in those of the control group. Compared with the control group, the observation group had dysphagia significantly improved (Chi-square=2.479, P=0.013). After intervention, the patients had gradeⅠ,Ⅱ, Ⅲ and Ⅳ comfortableness accounting for 42.31% (22 cases), 28.85%(15 cases), 23.08%(12 cases)[JP+1] and 5.77%(3 cases) respectively in the observation group, which were superior to those in the control group[21.15%(11 cases), 23.08%(12 cases), 34.62%(18 cases) and 21.15%(11 cases)] with significant difference (Chi-square=3.057, P=0.002). The incidences of aspiration pneumonia [5.77% (3 cases) vs 25.00% (13 cases), Chi-square=5.983, P=0.005] and salivation[7.69% (4 cases) vs 28.85% (15 cases), Chi-square=7.792, P=0.000] were significantly lower in the observation group than the control group. After intervention, the patients with Parkinson′s disease in stages 1.0,1.5,2.0,2.5,3.0 and 4.0 were 22,3, 4,2, 1 and 0 case in the observation group, which were better than those in the control group (12,5, 8,4, 2,1 cases, respectively), and the difference was statistically significant (Chi-square= 2.432, P=0.015). Conclusion Mendelssohn′s techniques and feeding training are helpful to improve swallowing function, reduce the incidences of aspiration pneumonia and salivation, and improve patient′s comfortableness in the elderly patients with Parkinson′s disease and dysphagia.
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