CTAR联合吞咽低频电刺激治疗CS后DAS患者的效果  

Effect of CTAR combined with low-frequency electrical stimulation of swallowing on DAS patients after CS

作　　者：刘蕊 王景涛[2] 谭志梅[3] LIU Rui;WANG Jing-tao;TAN Zhi-mei

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

出　　处：《中国疗养医学》2024年第5期86-90,共5页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年1月至2023年9月收治的84例CS后DAS患者进行回顾性研究,按治疗方案不同分为参照组(n=42)、研究组(n=42)。其中采用吞咽低频电刺激治疗的患者设为参照组,采用CTAR联合吞咽低频电刺激治疗的患者设为研究组。比较两组治疗前、治疗4周后吞咽功能障碍分级情况、标准吞咽功能评定量表(SSA)评分、功能性经口舌摄食量表(FOIS)评分、舌骨喉活动度、表面肌电图、吞咽障碍特异性生命质量量表(SWAL-QOL)评分。结果研究组治疗4周后吞咽功能障碍改善情况优于参照组(P<0.05);研究组治疗4周后SSA评分为(24.18±2.12)分,低于参照组(28.79±3.77)分,FOIS评分为(5.68±0.45)分,高于参照组(4.63±0.51)分(P<0.05);研究组治疗4周后舌骨前移、上移活动度分别为(11.47±2.55)mm、(17.38±4.59)mm,高于参照组(8.25±1.06)mm、(14.03±4.56)mm(P<0.05);研究组治疗4周后最大波幅为(725.38±55.02)V,高于参照组(605.98±49.65)V,吞咽时程为(1.11±0.15)s,短于参照组(1.33±0.21)s(P<0.05);研究组治疗4周后SWAL-QOL评分为(125.32±15.32)分,高于参照组(102.54±14.25)分(P<0.05)。结论CTAR联合吞咽低频电刺激治疗CS后DAS患者可有效提高舌骨喉活动度,改善吞咽、摄食功能,促进生活质量提升。Objective To explore the efficacy of chin tuck against resistance(CTAR)combined with low-frequency electrical stimulation of swallowing in the treatment of dysphagia after action stroke(DAS)patients after cerebral stroke(CS).Methods A retrospective study was conducted on 84 patients with post-CS DAS admitted to the Rehabilitation Department of Yucheng County People's Hospital from January 2021 to September 2023 by paired case-control study method,and they were divided into reference group(n=42)and study group(n=42)according to different treatment regimens.The patients receiving low-frequency electrical stimulation of swallowing were set as the reference group,and those receiving CTAR combined with low-frequency electrical stimulation of swallowing were set as the study group.The classification of swallowing dysfunction,standardized swallowing assessment(SSA)scores,functional oral intake scale(FOIS)scores,hyolaryngeal activity,surface electromyography and swallowing quality of life(SWAL-QOL)scores were compared between the two groups before treatment and 4 weeks after treatment.Results After 4 weeks of treatment,the improvement of swallowing dysfunction in the study group was better than that in the control group(P<0.05).After 4 weeks of treatment,the SSA score of the study group was(24.18±2.12)points,lower than that of the reference group(28.79±3.77)points,the FOIS score was(5.68±0.45)points,higher than that of the reference group(4.63±0.51)points(P<0.05).After 4 weeks of treatment,the anterior and upward motion of hyoid in the study group were(11.47±2.55)mm and(17.38±4.59)mm,respectively,which were higher than those in the control group(8.25±1.06)mm and(14.03±4.56)mm(P<0.05).After 4 weeks of treatment,the maximum amplitude of the study group was(725.38±55.02)V,higher than that of the reference group(605.98±49.65)V,and the swallowing time was(1.11±0.15)s,shorter than that of the reference group(1.33±0.21)s(P<0.05).The SWAL-QOL score of the study group was(125.32±15.32)points after 4 weeks of treatmen

关 键 词：下颏抗阻力训练 吞咽低频电刺激 脑卒中 吞咽障碍 舌骨喉活动度 摄食功能 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]