生物电刺激联合口肌训练治疗5~7岁痉挛型脑瘫吞咽障碍患儿的疗效观察  

Observation on the therapeutic effect of bioelectric stimulation combined with oral muscle training on 5-7 years old children with spastic cerebral palsy and dysphagia

作　　者：李蔷[1] 佟南 车凤凤 杨丽兰[1] 李丹 LI Qiang;TONG Nan;CHE Fengfeng;YANG Lian;LI Dan(Shenzhen Children’s Hospital,Shenzhen 518026,China;The Second People’s Hospital of Shenzhen,Shenzhen 518000,China)

机构地区：[1]深圳市儿童医院,广东深圳518026 [2]深圳市第二人民医院,广东深圳518000

出　　处：《中国实用神经疾病杂志》2024年第5期600-604,共5页Chinese Journal of Practical Nervous Diseases

基　　金：广东省医学科学技术研究基金(编号:WSTJJ20201121-05)。

摘　　要：目的 探讨生物电刺激联合口肌训练治疗5~7岁痉挛型脑瘫吞咽障碍患儿的临床疗效。方法采用前瞻性研究,选取深圳市儿童医院2020-01—2023-06收治的101例5~7岁痉挛型脑瘫吞咽障碍患儿为研究对象,随机数字表法分为联合组(生物电刺激联合口肌训练)51例,对照组(口肌训练)50例,2组患儿均治疗3个月。比较2组患儿临床疗效、治疗前后吞咽功能、舌骨复合体移动度以及口运动功能。结果 联合组临床总有效率高于对照组(92.16%比78.00%,P<0.05);治疗后,联合组口腔期[(8.94±0.76)分]、咽期[(4.04±0.80)分]、食管期得分[(1.41±0.50)分]以及DDS总分[(14.39±2.01)分]均低于对照组[(10.82±0.80)分、(4.48±0.50)分、(2.02±0.80)分、(17.60±1.50)分](P<0.05);治疗后,联合组患儿舌骨上移[(15.10±2.11)mm]、前移[(10.51±1.07)mm],甲状软骨上移[(22.51±3.00)mm]、前移[(4.51±0.95)mm]范围均明显大于对照组[(13.22±1.84)mm、(9.10±1.47)mm、(21.10±1.85)mm、(3.52±1.03)mm](P<0.05);治疗后,联合组患儿下颌[(18.61±3.22)分]、唇[(16.51±1.47)分]以及舌运动得分[(15.84±1.10)分]均高于对照组[(16.50±2.84)分、(14.84±1.99)分、(14.10±0.84)分](P<0.05)。结论 生物电刺激联合口肌训练能有效改善5~7岁痉挛型脑瘫吞咽障碍患儿吞咽障碍水平、舌骨复合体移动度与口运动能力,且提高临床疗效。Objective To investigate the clinical efficacy of bioelectric stimulation combined with oral muscle training in the treatment of 5-7 years old children with spastic cerebral palsy and dysphagia.Methods A prospective study was conducted,selecting 101 children aged 5-7 with spastic cerebral palsy and swallowing disorders admitted to Shenzhen Children's Hospital from January 2020 to June 2023 as the study subjects.They were randomly divided into the combination group(bioelectric stimulation combined with oral muscle training)of 51 cases and the control group(oral muscle training)of 50 cases,with both groups receiving treatment for 3 months.The clinical efficacy,swallowing function,hyoid complex mobility,and oral motor function were compared between two groups before and after treatment.Results The total clinical effective rate of the combination group was higher than that of the control group(92.16%vs 78.00%,P<0.05).After treatment,the combined group had lower scores in the oral phase((8.94±0.76)points),pharyngeal phase((4.04±0.80)points),esophageal phase((1.41±0.50)points),and total DDS score((14.39±2.01)points)compared to the control group((10.82±0.80)points,(4.48±0.50)points,(2.02±0.80)points,and(17.60±1.50)points,respectively,all P<0.05).After treatment,the range of hyoid bone upward movement((15.10±2.11)mm),forward movement((10.51±1.07)mm),thyroid cartilage upward movement((22.51±3.00)mm),forward movement((4.51±0.95)mm)in the combined group was significantly larger than that in the control group((13.22±1.84)mm,(9.10±1.47)mm,(21.10±1.85)mm,(3.52±1.03)mm,respectively,all P<0.05).After treatment,the mandibular((18.61±3.22)points),lip((16.51±1.47)points),and tongue movement scores((15.84±1.10)points)of the combined group were higher than those of the control group((16.50±2.84)points,(14.84±1.99)points,and(14.10±0.84)points,respectively,all P<0.05).Conclusion The combination of bioelectric stimulation and oral muscle training can effectively improve the level of swallowing disorders,hyoid compl

关 键 词：生物电刺激 口肌训练 痉挛型脑瘫 吞咽障碍 

分 类 号：R742.3[医药卫生—神经病学与精神病学]