早期咽喉肌训练对假性延髓麻痹患者椎基底动脉血流的影响  

Effects of early throat muscle training on vertebral-basilar artery blood flow in patients with pseudobulbar palsy

作　　者：成祥林[1] 赵成三[1] 汪华[1] 马兰[1] 

机构地区：[1]荆州市第一人民医院神经科,湖北省荆州市434000

出　　处：《中国临床康复》2005年第25期17-19,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨早期咽喉肌训练对假性延髓麻痹患者椎基底动脉血流的影响,并与健康人做对比。方法:①选择2002-03/2004-10武汉大学中南医院神经科和荆州市第一人民医院神经科住院假性延髓麻痹患者32例,男19例,女13例。均自愿参加。随机将患者分为2组:康复组17例,对照组15例。选择同期健康体检自愿参与者34人为健康对照组,男18人,女16人。②两组患者均给予脑梗死常规药物治疗。康复组在常规药物治疗的基础上在入院第1天就接受咽喉肌的训练。具体方法为发音训练,舌部运动训练,面部、下颌及喉部运动,屏气发声运动,进食训练。③左、右椎动脉和基底动脉的平均血流速度检测应用经颅多普勒超声。④计量资料资料组间差异性测定采用方差分析、q检验;组内比较采用配对t检验。结果:假性延髓麻痹患者32例,健康者34人均进入结果分析。①干预前基底动脉、右椎动脉和左椎动脉平均血流速度:康复组与对照组差异不明显(P>0.05),康复组和对照组均明显低于健康对照组犤(34.24±9.67),(33.46±10.08),(32.76±10.85);(32.67±8.34),(32.56±9.29),(33.12±9.15)cm/s;(44.26±11.43),(45.23±12.23),(45.46±10.33)cm/s,q=6.32,7.24,13.14,P<0.01犦。②干预后基底动脉、右椎动脉和左椎动脉平均血流速度平均血流速度:康复组明显高于治疗前犤(43.12±9.87),(45.48±11.67),(44.81±9.57),q=8.51,9.14,11.37,P<0.01犦;对照组明显高于治疗前犤(38.96±8.16),(40.37±10.74),(39.97±8.24)cm/s,q=5.46,7.65,6.67,P<0.01);康复组与健康对照组相近(P>0.05),对照组明显低于健康对照组(q=2.96,3.72,3.69,P<0.05);康复组明显高于对照组(t=3.57,3.16,3.06,P<0.05)。结论:早期咽喉肌训练可以增加假性延髓麻痹患者椎基底动脉的血流量,且治疗后血流量与健康人接近。AIM： To observe effects of early throat muscle training on vertebral-basilar artery blood flow in patients with pseudobulbar palsy and compare with healthy people. METHODS： ① Thirty-two pseudobulbar palsy inpatients were selected from Department of Neurology of Zhongnan Hospital of Wuhan University and Department of Neurology of First People＇s Hospital of Jingzhou, including 19 males and 13 females. The patients who took part in the trial voluntarily were divided randomly into 2 groups： rehabilitation groups with 17 patients and control groups with 15 patients. Meanwhile 34 patients of health examination were chosen as health control groups with 18 males and 16 females. ② The patients in the two groups were all treated with cerebral infarction. The patients in rehabilitation groups were treated with routine drug treatment for throat muscle training based on the routine drug treatment at the first day of hospitalization. The specific methods were pronunciation training, tongue movement training, face, lower jaw and throat movement, breathholding phonation movement and eating training. ③ The average blood stream speed of left and right vertebral artery and basilar artery was detected with transcranial Doppler ultrasound. ④ The differences of the groups of measurement data were detected by analysis of variance and q-test; The comparison of the groups was done by pair-matching t-test. RESULTS： Thirty-two pseudobulbar palsy patients and 34 healthy people were all involved in the result analysis. ① Before intervention the average cerebral blood flow of basilar artery, right and left vertebral-artery： The differences of average blood stream speed between the two groups were insignificant （P 〉 0.05 ）. It was significantly lower in rehabilitation groups and control groups than that in healthy control group [（34.24±9.67）,（33.46±10.08）, （32.76±10.85）; （32.67±8.34）, （32.56±9.29）,（33.12±9.15） cm/s; （44.26±11.43）, （45.23±12.23）, （45.46±10.33）cm/s, （q=6.

关 键 词：血流速度 超声检查 多普勒 经颅 脑梗塞 早期咽喉肌训练 假性延髓麻痹 

分 类 号：R745[医药卫生—神经病学与精神病学]