振动负荷刷洗法在脑卒中口腔期吞咽障碍患者中的应用效果研究

doi:10.3761/j.issn.0254-1769.2025.11.008

摘要/Abstract

摘要：

目的评价声波靶点振动负荷刷洗法在脑卒中口腔期吞咽障碍患者中的康复效果，为改善脑卒中患者口腔期吞咽障碍提供参考。方法选取2023年10月—2024年5月在江苏省南京市某三级甲等医院康复科住院的60例脑卒中吞咽障碍患者作为研究对象，随机分为试验组和对照组，每组各30例。两组均接受常规吞咽功能训练，试验组采用声波靶点振动负荷刷洗技术进行口腔护理，对照组常规采用手动牙刷进行口腔护理，干预30 d后观察两组Gugging吞咽功能评估表（Gugging Swallowing Screen，GUSS）评分、改良Beck口腔评分、吞咽障碍相关并发症发生率、吞咽障碍特异性生活质量量表（Swallowing Quality of Life，SWAL-QOL）评分及口腔护理满意度得分情况。结果无样本脱落。干预后，试验组GUSS得分高于对照组，差异具有统计学意义（Z=-4.239，P<0.001）；改良Beck口腔评分和吞咽障碍相关总体并发症发生率低于对照组，差异具有统计学意义（均P<0.05）；试验组的SWAL-QOL得分和口腔护理满意度得分高于对照组，差异具有统计学意义（均P<0.001）。结论声波靶点振动负荷刷洗法能够改善脑卒中口腔期吞咽障碍患者的吞咽功能，提升口腔清洁程度，减少吞咽障碍相关并发症的发生，并有效提高患者的生活质量和护理满意度。

关键词: 脑卒中, 吞咽障碍, 靶点刺激, 振动负荷刷洗技术, 口腔护理

Abstract:

Objective To evaluate the rehabilitative effect of targeted sonic vibration load brushing method in stroke patients with oral phase swallowing disorders. Methods A total of 60 stroke patients with swallowing disorders，who hospitalized in the rehabilitation department of a Grade III Class A hospital in Nanjing City from October 2023 to May 2024，were randomly assigned to an experimental group and a control group，with 30 patients in each group. Both groups received the conventional swallowing function training. The experimental group received targeted sonic vibration load brushing therapy，while the control group received routine oral care with manual toothbrushes. After 30 days of intervention，the swallowing function（Gugging Swallowing Screen，GUSS），modified Beck oral score，incidence of swallowing disorder-related complications，Swallowing Quality of Life（SWAL-QOL） scores，and oral care satisfaction were assessed in both groups. Results No sample detachment. After the intervention，the GUSS score for the experimental group was significantly higher than that of the control group，with a statistical difference（Z=-4.239， P<0.001）. Additionally，the modified Beck oral score and the overall complications rate related to swallowing disorders in the experimental group were significantly lower than those in the control group（both P<0.05）. Furthermore，the SWAL-QOL score and the oral care satisfaction score were both higher in the experimental group compared to those in the control group，with statistically significant differences（both P<0.001）. Conclusion Targeted sonic vibration load brushing method significantly improves swallowing function，enhances oral cleanliness，reduces the occurrence of swallowing disorder-related complications，and effectively improves patients’ quality of life and nursing satisfaction.

Key words: Stroke, Dysphagia, Targeted Stimulation, Vibration Load Brushing Technology, Oral Care

汤一帆, 毛二莉, 吴雏燕, 周秋敏, 郭川, 丁慧, 周莉, 孙慧. 振动负荷刷洗法在脑卒中口腔期吞咽障碍患者中的应用效果研究[J]. 中华护理杂志, 2025, 60(11): 1330-1336.

TANG Yifan, MAO Erli, WU Chuyan, ZHOU Qiumin, GUO Chuan, DING Hui, ZHOU Li, SUN Hui. The effectiveness of targeted sonic vibration load brushing method in stroke patients with oral stage swallowing disorders[J]. Chinese Journal of Nursing, 2025, 60(11): 1330-1336.

图/表 6

图1 面颊部声波振动牙刷按摩位点与移动顺序

Figure 1 The massage sites and movement sequence of the sonic vibration toothbrush on the cheek

表1 两组一般资料的比较

Table 1 General baseline data of the 2 groups of patients

表2 两组吞咽功能的比较[分，M（P25，P75）]

Table 2 GUSS scores of 2 groups of patients[score，M（P25，P75）]

表3 两组口腔清洁状态的比较（分，$\bar{x}±s$）

Table 3 Comparison of boral cleanliness status between the 2 groups（scores, $\bar{x}±s$）

表4 两组吞咽障碍相关并发症发生率的比较[例（百分率，%）]

Table 4 Comparison of the incidence of swallowing complications between the 2 groups[case（percentage,%）]

表5 两组吞咽障碍特异性生活质量量表得分的比较（分，$\bar{x}±s$$）

Table 5 Comparison of SWAL-QOL scores between the 2 groups（scores，$\bar{x}±s$）

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