神经肌肉电刺激单独或联合不同频率经颅磁刺激治疗脑卒中吞咽障碍的疗效分析  

Efficacy Analysis of Neurom uscular Electrical Stimulation Alone or in Combination with Different Frequencies of Transcranial Magnetic Stimulation in the Treatment of Dysphagia after Stroke

作　　者：杜灿荣[1] 龙耀斌[1] 覃东华[2] 黄福才[1] 覃明安 DU Canrong;LONG Yaobin;QIN Donghua;HUANG Fucai;QIN Mingan(The Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region,530007 China;The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region,530021 China)

机构地区：[1]广西医科大学第二附属医院,广西南宁530007 [2]广西医科大学第一附属医院,广西南宁530021

出　　处：《中外医疗》2022年第9期19-23,共5页China & Foreign Medical Treatment

基　　金：广西壮族自治区卫计委自筹经费科研课题(Z2016316);广西壮族自治区临床重点专科建设项目(桂卫医发﹝2018﹞6号)。

摘　　要：目的研究神经肌肉电刺激(NMES)和不同频率重复经颅磁刺激(rTMS)单独或联合方案治疗脑卒中患者吞咽功能障碍的效果。方法方便选取2019年6月—2020年12月广西医科大学第二附属医院康复医学科收治的90例脑卒中后吞咽障碍患者,根据随机数表平均分为A组(常规吞咽功能训练)、B组(NMES)、C组(低频rTMS)、D组(高频rTMS)、E组(NMES+低频rTMS)和F组(NMES+高频rTMS),每组15例。对比洼田饮水实验评分、吞咽功能、营养状况。结果治疗后,E组、F组蛙田饮水实验评分、标准吞咽功能评价量表评分均低于A、B、C、D组,差异有统计学意义(P<0.05);治疗后,E组、F组治疗后血红蛋白水平高于A、B、C、D组,差异有统计学意义(P<0.05);且治疗后白蛋白水平高于A、B、C、D组,差异有统计学意义(P<0.05)。结论NMES、低频或高频rTMS均能改善脑卒中患者吞咽功能障碍,NMES和rTMS联合治疗效果优于单独NMES或rTMS。Objective To study the effects of neuromuscular electrical stimulation(NMES)and repetitive transcranial magnetic stimulation(rTMS)at different frequencies alone or in combination in the treatment of dysphagia in stroke patients.Methods From June 2019 to December 2020,90 patients with post-stroke dysphagia admitted to the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Guangxi Medical University were conveniently selected and divided into group A(conventional swallowing function training),group B(NMES),group C(low frequency rTMS),group D(high frequency rTMS),group E(NMES+low frequency rTMS)and group F(NMES+high frequency rTMS)according to random number table,15 cases in each group.The scores of water drinking test,swallowing function and nutritional status were compared.Results Affter treatment,the scores of the frog field drinking test and the standard swallowing function evaluation scale scores of groups E and F were lower than those of groups A,B,C,and D,the difference was statistically significant(P<0.05).Affter treatment,the levels of hemoglobin in groups E and F after treatment were higher than those in groups A,B,C,and D,the difference was statistically significant(P<0.05),and the albumin level after treatment was significantly higher than that in groups A,B,C,and D,the difference was statistically significant(P<0.05).Conclusion NMES,low-frequency or high-frequency rTMS can improve swallowing dysfunction in stroke patients,and the combined treatment effect of NMES and rTMS is better than that of NMES or rTMS alone.

关 键 词：脑卒中 吞咽障碍 经颅磁刺激 神经肌肉电刺激 

分 类 号：R5[医药卫生—内科学]