神经肌肉电刺激对脑卒中后吞咽障碍患者吞咽功能及其表面肌电图的影响  

The effect of neuromuscular electrical stimulation on swallowing function after stroke

作　　者：苏文华[1] 阎文静[1] 钟明华[1] 林延敏[1] 高呈飞 朱其秀[1] 

机构地区：[1]青岛大学附属医院康复科,青岛266000

出　　处：《中华物理医学与康复杂志》2015年第3期183-186,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的 观察神经肌肉电刺激（NMES）治疗脑卒中恢复期吞咽障碍患者的临床疗效,并探讨表面肌电图在脑卒中患者吞咽障碍评估中的应用价值.方法 将脑卒中恢复期吞咽障碍患者40例按随机数字表法随机分为实验组（20例）和对照组（20例）,2组患者均给予神经内科常规药物治疗和常规吞咽训练,实验组患者在此基础上增加NMES治疗.2组患者均于治疗前和治疗2周后（治疗后）进行吞咽功能评定和sEMG检测.结果 治疗后,实验组患者的吞咽障碍评分为（7.65 ±0.88）分,与组内治疗前的（2.75 ±0.64）分和对照组治疗后的（6.10±0.85）分比较,差异均有统计学意义（P＜0.05）.治疗后,2组患者舌骨上肌群的sEMG最大波幅和吞咽时程较组内治疗前显著改善（P＜0.05）,且实验组治疗后的sEMG最大波幅和吞咽时程均显著优于对照组治疗后（P＜0.05）.结论 NMES结合常规吞咽训练可显著改善脑卒中恢复期吞咽障碍患者的吞咽功能,且sEMG可作为评估脑卒中患者吞咽障碍的有效方法.Objective To observe the clinical therapeutic effects of neuromuscular electric stimulation （NMES） on patients with swallowing disorders after stroke and to assess the value of surface electromyography （sEMG）.Methods Forty stroke survivors with swallowing disorders were divided into a treatment group （20 cases） and a control group （20 cases） using a random number table.All of the patients were given routine medication and conventional swallowing training lasting 2 weeks,on the basis of which the patients in the treatment group were also given electrical stimulation.The seriousness of their swallowing disorders was evaluated and surface electromyographs were recorded for both groups before and after the 2 weeks of treatment.Results After treatment,the average dysphagia rating in the treatment group was significantly higher than before treatment,and significantly higher than that of the control group.sEMG of the suprahyoid muscles showed that the swallowing duration of both groups had significantly improved,but the values of the treatment group were significantly better than those of the control group.Conclusions NMES plus conventional swallowing training can significantly improve swallowing function for patients with swallowing disorders after stroke.sEMG can be regarded as an effective method for assessing swallowing disorders.

关 键 词：吞咽障碍 神经肌肉电刺激 脑卒中 表面肌电图 

分 类 号：R743.3[医药卫生—神经病学与精神病学]