舌咽联合刺激法治疗脑卒中后吞咽障碍的临床研究  

Effect of Pharyngoglossal Combined Stimulation Treatment on Dysphagia Patients after Stroke

作　　者：孙漓[1] 朱治山[1] 郭瑾[1] 

机构地区：[1]深圳市第五人民医院神经内科,广东深圳518000

出　　处：《江西医学院学报》2009年第3期89-91,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的对比分析舌咽刺激法康复治疗脑卒中后吞咽障碍的疗效,探讨其临床实用意义。方法将76例脑卒中后吞咽障碍患者随机分为试验组、针灸组和对照组,试验组(n=30)患者应用舌咽联合刺激法(即联合应用舌咽冷刺激、经皮电刺激、针灸法)进行康复,针灸组(n=20)仅应用针灸法康复,对照组(n=26)不进行吞咽康复。应用洼田饮水试验和电视透视舌咽检查评估吞咽功能,对比分析舌咽联合刺激法的康复疗效。结果吞咽功能改善的有效率、显效率试验组为86.7%、30.0%,针灸组为65.0%、15.0%,对照组为50.0%、7.7%,3组比较有显著性差异(P<0.05或P<0.01)。口腔期、咽期和喉期吞咽障碍者分别占9.2%(7/76)、72.4%(55/76)和18.4%(14/76),口腔期、咽期康复治疗有效率和显效率优于喉期吞咽障碍者(42.9%、85.7%,25.5%、87.3%vs 7.1%、42.9%,P<0.05或P<0.01)。结论舌咽联合刺激法康复脑卒中后吞咽障碍的疗效显著,且明显优于单一的舌咽部刺激疗法。Objective To investigate the effect of pharyngoglossal combined stimulation treatment on acute dysphagia patients after stroke. Methods 76 cases of dysphagia patients after stroke were divided into treatment group, acupuncture group and control group randomly. The patients in treatment group（n=30） were treated with pharyngoglossal combined stimulation treatment, including pharyngoglossal cold stimulation, transcutaneous electric stimulation and acupuncture stimulation. The patients in acupuncture group（n = 20） were treated with acupuncture stimulation,and the cases in control group （n=26） were left untreated. All cases＇ swallowing functions were assessed by bedside water swallowing test and videofluography. Results The significant effectiveness rate was 30.0 % and the moderate effectiveness rate was 86.7 % in treatment group, compared with 15.0% and 65.0% in acupuncture group, and 7.7% and 50.0% in the control group. There was significant difference between three groups （P〈0.05 or P〈0.01）. The ratio of dysphagia patients in oral,pharyngeal and laryngeal phase were 92% （7/76）, 72.4% （55/ 76） and 18. 4% （14/76） indidually. The effectiue rate and the significant rate of rehabititation treatment for dysphagia patients in oral and pharyngeal phase were better than those in laryngeal phase（42.9%,85.7%;25.5%,87.3% vs 7.1% ,42. 9% ,P〈0. 05 or P〈0. 01）. Conclusion Pharyngoglossal combined stimulation treatment has an remarkable effect on dysphagia patients after stroke,and it is better than any other single pharyngoglossal rehabilitation treatment.

关 键 词：脑卒中 吞咽障碍 康复治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]