改良洼田饮水试验在脑卒中吞咽障碍患者中的研究应用

摘要

Objective To analyze the effect of modified water swallow test in stroke patients with dysphagia and to evaluate the clinical research value.Methods A total of 616 stroke patients with dysphagia admitted to our hospital from July 2016 to January 2018 were selected as research objects,and were divided into control group and experimental group by random number table method,with 308 cases in each group.Two groups of patients were examined by swallowing radiography,on the basis of which,the patients in experimental group were tested by improved wa-Tian drinking water test method,and the patients in control group were tested by traditional wa-Tian drinking water test method. Comparative analysis of two groups of patients aspiration screening rate,drinking water quantity,drinking water time and other indicators.Results The amount of drinking water in the experimental group (19.5±3.2) ml which was less than that in the control group (28.5±2.3) ml,and the difference was statistically significant (t=26.9890,P＜0.05).And the total drinking time (10.5±2.3) s was shorter than that of the control group ([22.5±2.0]) s,the difference was statistically significant (t=69.0953,P=0.0000＜0.05).The cough and choking rate and the incidence of aspiration pneumonia in experimental group were less than those in control group,and the difference was statistically significant (P＜0.05).The positive rate of aspiration and swallowing radiography in experimental group was higher than that in control group,and the negative rate of aspiration and swallowing radiography was lower than that in control group,the difference was statistically significant(P＜0.05).Conclusion Improved water swallow test increase the diagnosis for aspiration in screening acute stroke patients with dysphagia and maintain a stable swallowing function.Therefore,it is feasible to substitute the traditional water swallow test with modified one.%目的 分析脑卒中吞咽障碍患者行改良洼田饮水试验的效果,评定临床研究价值.方法 选取2016年7月～2018年1月我院收治的616例脑卒中吞咽障碍患者作为研究对象,采用随机数字表法将其分为对照组、实验组,每组308例.两组患者均予以吞咽造影检查,在此基础上,实验组患者予以改良洼田饮水试验法进行病症的测定,对照组予以传统洼田饮水实验法进行测定.比较分析两组患者误吸筛查率、饮水量、饮水时间等指标.结果 实验组患者的饮水量[(19.5±3.2)ml]少于对照组的(28.5±2.3)ml,差异有统计学意义(t=26.9890,P＜0.05);且全部饮完时间[(10.5±2.3)s]短于对照组[(22.5±2.0)s],差异有统计学意义(t=69.0953,P=0.0000).实验组患者的咳呛率以及吸入性肺炎发生率均低于对照组,差异有统计学意义(P＜0.05).实验组患者的误吸阳性率以及吞咽造影检查阳性率要高于对照组,误吸阴性率以及吞咽造影检查阴性率低于对照组,差异均有统计学意义(P＜0.05).结论 改良洼田饮水试验筛查急性脑卒中后吞咽障碍患者其诊断误吸结果得到提升,吞咽功能依然可行,因此通过改良洼田饮水法,代替传统洼田饮水实验法的临床价值可行.