5 Hz高频经颅磁刺激联合吞咽康复训练在卒中后吞咽障碍患者中的效果评价  

Effect evaluation of 5 Hz high frequency transcranial magnetic stimulation combined with swallowing rehabilitation training in patients with dysphagia after stroke

作　　者：刘蕊 王景涛[2] 谭志梅[3] Liu Rui;Wang Jingtao;Tan Zhimei

机构地区：[1]虞城县人民医院内科,476300 [2]郑州大学第一附属医院神经内科,450000 [3]郑州大学第一附属医院康复科,450000

出　　处：《中国疗养医学》2022年第10期1092-1095,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的研究5 Hz高频经颅磁刺激联合吞咽康复训练在卒中后吞咽障碍患者中的应用效果。方法选取虞城县人民医院2019年9月至2021年9月收治的卒中后吞咽障碍患者76例,且均为非急性期单侧大脑半球卒中后吞咽障碍。采用随机数字表将患者分为常规组和研究组各38例。常规组给予吞咽康复训练,研究组在上述基础上给予5 Hz高频经颅磁刺激。比较两组临床疗效、治疗前后标准吞咽功能评价量表(SSA)、吞咽障碍程度(VFSS)、渗透-误吸评价量表(PAS)评分、血清营养状态指标[血红蛋白(Hb)、血清前白蛋白(PAB)、血清白蛋白(ALB)、转铁蛋白(TRF)]、血清胱抑素C(CysC)、血清S100B蛋白(S100B)、血清同型半胱氨酸(Hcy)、血清β_(2)-微球蛋白(β_(2)-MG)、血清炎症因子[肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]。结果研究组临床总有效率为97.37%,高于常规组的78.95%(P<0.05);治疗后与常规组相比,研究组VFSS评分较高,SSA、PAS评分较低(P<0.001);治疗后血清Hb、PAB、ALB、TRF水平组间比较,研究组高于常规组(P<0.01);治疗后研究组血清S100B、hs-CRP、CysC、IL-6、Hcy、TNF-α、β_(2)-MG水平均较常规组低(P<0.01)。结论5 Hz高频经颅磁刺激联合吞咽康复训练在非急性期单侧大脑半球卒中后吞咽障碍患者中的效果显著,可改善机体营养状态,抑制机体炎症反应,从而进一步提升患者吞咽能力。Objective To investigate the application effect of 5 Hz high frequency transcranial magnetic stimulation combined with swallowing rehabilitation training in patients with dysphagia after stroke.Methods A total of 76 patients with dysphagia after stroke admitted to Yucheng County People's Hospital from September 2019 to September 2021 were selected,and all of them had dysphagia after unilateral cerebral hemisphere stroke in non-acute stage.The patients were divided into conventional group and study group by the random number table,with 38 cases in each group.The conventional group was given swallowing rehabilitation training,and the study group was given 5 Hz high frequency transcranial magnetic stimulation on the basis of the conventional group.The two groups were compared before and after treatment in terms of the clinical efficacy,standardized swallowing assessment(SSA),degree of video fluoroscopic swallowing study(VFSS),penetration aspiration scale(PAS)score,serum nutritional status indicators[hemoglobin(Hb),serum prealbumin(PAB),serum albumin(ALB),transferrin(TRF)],cystatin C(CysC),serum S100B protein(S100B),serum homocysteine(Hcy),serum β_(2)-microglobulin(β_(2)-MG),serum inflammatory factors[tumor necrosis factor(TNF-α),interleukin-6(IL-6),and high sensitivity C-reactive protein(hs-CRP)].Results The total effective rate of the study group was 97.37%,which was higher than 78.95%of the conventional group(P<0.05).After treatment,compared with the conventional group,the VFSS score of the study group was higher,and the SSA and PAS scores were lower(P<0.001).After treatment,the serum Hb,PAB,ALB and TRF levels in the study group were higher than those in the conventional group(P<0.01).After treatment,the serum levels of S100B,hs-CRP,CysC,IL-6,Hcy,TNF-α and β_(2)-MG in the study group were lower than those in the conventional group(P<0.01).Conclusion 5 Hz high frequency transcranial magnetic stimulation combined with swallowing rehabilitation training has a significant effect on patients with dysphagia after u

关 键 词：高频经颅磁刺激 吞咽康复训练 非急性期 单侧大脑半球卒中 吞咽障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]