Deliberate ingestion of foreign bodies as a form of self-harm among inpatients within forensic mental health and intellectual disability services

Deliberate foreign body ingestion is a significant issue in prison and psychiatric settings. It is associated with serious physical complications, including bowel obstruction, perforation and haemorrhage. Episodes of deliberate foreign body ingestion were identified retrospectively from 5417 incident records from two inpatient forensic services (one mental health and one intellectual disability) over a one year timeframe, using related search terms. Rates were compared according to gender, diagnosis and level of security. Incidents of deliberate foreign body ingestion were found to occur on average every 2.7 days across the study population, with 133 incidents recorded over a one year period, accounted for by 27 patients. Women and patients in lower levels of security were significantly more likely to engage in deliberate foreign body ingestion. Staff responses to this behaviour were highly variable. Deliberate foreign body ingestion occurs frequently within inpatient forensic services, and can have significantly detrimental physical implications for affected patients. Further research should investigate the psychiatric and intellectual disability profile of such individuals in further detail, as well as exploring patient narratives; both of which will help inform development of treatment strategies.     

基于视频透视吞咽功能研究评价针刺阿呛组穴联合康复训练治疗脑卒中后吞咽障碍的疗效分析

目的 基于视频透视吞咽功能研究（video fluoroscopic swallowing study, VFSS）评价针刺阿呛组穴联合康复训练治疗脑卒中后吞咽障碍的疗效。方法 将50例脑卒中后吞咽功能障碍的患者,随机分为对照组和治疗组,每组25例。对照组仅采用康复训练,治疗组采用针刺阿呛组穴联合康复训练,比较两组患者治疗前及治疗30 d后VFSS评分及功能性经口摄食量表（functional oral intake scale, FOIS）评分。结果 两组治疗后FOIS评分均较治疗前升高,差异均有统计学意义（P＜0.05）,治疗组FOIS评分升高值显著大于对照组（P＜0.05）。与治疗前比较,两组治疗后吞食稀钡、浓钡、糊钡、包钡的VFSS评分均显著升高,差异均有统计学意义（P＜0.05）;且治疗组治疗后吞食稀钡、浓钡、糊钡的VFSS评分升高值显著大于对照组（P＜0.05）。结论 针刺阿呛组穴联合康复训练可以在一定程度上改善脑卒中后吞咽障碍患者的吞咽功能。     

针刺联合吞咽康复训练治疗卒中后吞咽障碍87例

目的 观察针刺联合吞咽康复训练治疗卒中后吞咽障碍的临床疗效。方法 将174例卒中后吞咽障碍患者随机分为治疗组和对照组,每组87例。治疗组给予针刺联合吞咽康复训练,对照组仅给予吞咽康复训练,隔日1次,2周为1个疗程,治疗60 d后评价临床疗效,治疗后3个月进行随访。采用洼田饮水试验和藤岛一郎吞咽障碍评分标准进行疗效评价。结果 与前一时点比较,两组治疗后和随访后洼田饮水试验评分均显著降低 （P<0.01）, 藤岛一郎吞咽障碍评分均显著升高（P<0.01）; 随访后,治疗组洼田饮水试验评分降低值及藤岛一郎吞咽障碍评分升高值显著大于对照组（P<0.01）。治疗组吞咽障碍复常率及临床疗效显著优于对照组（P<0.05）。结论 在吞咽康复训练的基础上,联用针刺疗法可提高卒中后吞咽障碍的临床疗效。