通讯作者: 秦茵, baby792305220@163.com

DOI：10.12201/bmr.202510.00033

Efficacy of Stratified Rehabilitation Based on FEES Assessment in Patients with Post-Stroke Dysphagia

• 摘要：目的 探讨基于喉镜吞咽功能评估（Fiberoptic Endoscopic Evaluation of Swallowing ，FEES）的吞咽障碍严重程度分层干预对卒中后吞咽障碍患者的疗效。方法 采用随机对照设计，纳入2024年6月—2025年6月中国人民解放军联勤保障部队第九〇〇医院收治的72例卒中后吞咽障碍患者，分为实验组和对照组。实验组根据FEES结合渗透误吸量（Penetration-Aspiration Scale, PAS）分为三级进行分层干预，对照组采用统一常规康复策略治疗，持续4周。比较两组患者吞咽功能改善程度，观察临床疗效。结果 干预4周后实验组总有效率显著优于对照组（P<0.05）；两组患者渗透/误吸量表、吞咽功能、洼田饮水试验评分较基线期均显著降低（P<0.05），功能性经口摄食量表、生活质量量表评分较治疗前均显著升高（P<0.05），且实验组改善幅度显著优于对照组（P<0.05）；治疗期间吸入性肺炎发生率实验组（2.8%）低于对照组（13.9%），差异无统计学意义(P=0.076)。结论 FEES-PAS指导的个性化分级干预对脑卒中后吞咽障碍疗效显著，能够有效促进患者吞咽功能恢复，具有临床推广价值。

  关键词： 脑卒中; 吞咽障碍; FEES; 个体化康复; 分级干预

   

  Abstract: Objective To investigate the efficacy of a severity-graded intervention protocol for post-stroke dysphagia based on Fiberoptic Endoscopic Evaluation of Swallowing (FEES) assessment. Methods This randomized controlled trial enrolled 72 patients with post-stroke dysphagia admitted to the 900th Hospital of PLA Joint Logistics Support Force from June 2024 to June 2025. Participants were divided into an experimental group and a control group. The experimental group received a stratified intervention based on three levels determined by Fiberoptic Endoscopic Evaluation of Swallowing (FEES) combined with the Penetration-Aspiration Scale (PAS), while the control group received standardized conventional rehabilitation therapy. Both groups underwent 4 weeks of treatment. The improvement in swallowing function and clinical efficacy were compared between the two groups. Results After 4 weeks of intervention, the overall response rate in the experimental group was significantly higher than in the control group (P<0.05). Compared to baseline, both groups showed significant reductions in the Penetration-Aspiration Scale score, swallowing function scores, and Water Swallow Test score (P<0.05), while scores on the Functional Oral Intake Scale and the Quality of Life scale showed significant increases compared to pre-treatment levels (P<0.05). Furthermore, the experimental group demonstrated significantly greater improvements in all scales compared to the control group (P<0.05). During the treatment period, the incidence of aspiration pneumonia in the experimental group (2.8%) was lower than that in the control group (13.9%), but the difference was not statistically significant (P = 0.076). Conclusion FEES-PAS guided personalized graded intervention significantly improves swallowing function in post-stroke dysphagia patients, effectively promoting functional recovery and demonstrating substantial clinical value for broader application.

  Key words: Stroke； Dysphagia； FEES；Individualized Rehabilitation；Graded intervention; ; ; ; 

  提交时间：2025-10-20

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• 序号	提交日期	编号	操作
  1	2025-10-10	bmr.202510.00033V1	下载

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