下颌收拢抗阻力运动配合早期VitalStim治疗仪对卒中后老年吞咽障碍患者康复效果的影响  

Effect of jaw retraction resistance exercise combined with early VitalStim therapy on rehabilitation of elderly patients with dysphagia after stroke

作　　者：周丽军[1] 冯雅娟[1] 贾晓沛[1] Zhou Lijun;Feng Yajuan;Jia Xiaopei(Department of Rehabilitation Medicine,Handan First Hospital,Handan 056004,Hebei Province,China)

机构地区：[1]邯郸市第一医院康复医学科,河北邯郸056004

出　　处：《中华老年多器官疾病杂志》2024年第6期442-446,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：河北省医学科学研究课题计划项目(20202435)。

摘　　要：目的 探讨下颌收拢抗阻力运动配合早期VitalStim治疗仪对卒中后老年吞咽障碍患者的康复效果。方法 选取2021年1月至2023年1月邯郸市第一医院收治的卒中后老年吞咽障碍患者124例作为研究对象,患者入院后依据康复干预方案不同分为观察组(n=60)与对照组(n=64)。观察组行下颌收拢抗阻力运动配合早期VitalStim治疗仪干预,对照组行早期VitalStim治疗仪干预。比较两组康复效果及干预前后吞咽功能、表面肌电检查指标、营养相关指标及生活质量评分差异。采用SPSS 22.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。结果 观察组总有效率(95.00%)显著高于对照组(82.81%),差异有统计学意义(P<0.05)。观察组干预后视频荧光吞咽摄影检查(VFSS)及洼田饮水实验评分显著低于干预前及对照组干预后,差异均有统计学意义(P<0.05)。观察组干预后表面肌电平均波幅显著高于干预前及对照组干预后,而表面肌电吞咽时限显著低于干预前及对照组干预后,差异均有统计学意义(P<0.05)。观察组干预后血清前白蛋白、血清白蛋白水平及微型营养评价精法评分显著高于干预前及对照组干预后,差异均有统计学意义(P<0.05)。观察组干预后世界卫生组织生存质量测定量表各维度评分显著高于干预前及对照组干预后,差异有统计学意义(P<0.05)。结论 下颌收拢抗阻力运动配合早期VitalStim治疗仪对卒中后老年吞咽障碍患者有较好的康复效果,在改善患者吞咽障碍的同时还能改善其营养状况、提高生活质量。Objective To explore the rehabilitation effects of jaw retraction resistance exercise combined with early VitalStim electrical stimulation on dysphagia patients after stroke.Methods A total of 124 elderly patients with dysphagia after stroke treated in our hospital from January 2021 to January 2023 were enrolled and divided into observation group(n=60)and control group(n=64)according to different rehabilitation intervention programs after admission.The observation group received jaw retraction resistance exercise combined with early VitalStim therapy,while the control group received early VitalStim therapy alone.The rehabilitation efficacy,as well as the differences in swallowing function,surface electromyography(sEMG)parameters,nutrition-related indicators,and quality of life scores before and after intervention,were compared between two groups.SPSS statistics 22.0 was used for statistical analysis.Student′s t test orχ^(2) test was performed for intergroup comparison depending on data type.Results The total effective rate was significantly higher in the observation group than the control group(95.00%vs 82.81%,P<0.05).The observation group obtained obviously lower scores of video fluorescence swallowing study(VFSS)and drinking water test after intervention when compared with the scores before intervention and those of the control group after intervention(P<0.05).The average sEMG amplitude was notably higher,while the sEMG swallowing duration was remarkably shorter in the observation group after intervention than those before intervention and in the control group after intervention(P<0.05).The serum levels of albumin and prealbumin,and the score of short-form mini-nutritional assessment in the observation group after intervention were significantly higher than those before intervention and those in the control group after intervention(P<0.05).The observation group also had higher scores of all dimensions of the World Health Organization quality of life assessment scale after intervention when compared with the

关 键 词：卒中 吞咽障碍 老年人 下颌收拢抗阻力运动 VitalStim治疗仪 

分 类 号：R493[医药卫生—康复医学] R592[医药卫生—临床医学]