神经肌肉电刺激联合舌肌训练治疗卒中后吞咽障碍患者的效果  

Effects of neuromuscular electrical stimulation combined with tongue muscle training on patients with swallowing dysfunction after stroke

作　　者：许鸿涛 乔盼盼[1] 桂飞飞 XU Hongtao;QIAO Panpan;GUI Feifei(Department of Rehabilitation Medicine of the First Affiliated Hospital of Henan University,Kaifeng 475000 Henan,China)

机构地区：[1]河南大学第一附属医院康复医学科,河南开封475000

出　　处：《中国民康医学》2024年第15期83-86,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察神经肌肉电刺激联合舌肌训练治疗卒中后吞咽障碍患者的效果。方法:回顾性分析2021年5月至2023年7月该院收治的84例卒中后吞咽障碍患者的临床资料,按照治疗方案不同将其分为对照组和观察组各42例。对照组给予舌肌训练治疗,观察组在对照组基础上联合神经肌肉电刺激治疗。比较两组临床疗效,治疗前后吞咽功能[标准吞咽功能评价量表(SSA)]、生命质量[吞咽生活质量量表(SWAL-QOL)]评分、吞咽时舌骨下肌群表面肌电图(sEGM)指标水平、舌骨喉复合体动度,以及并发症发生率。结果:观察组治疗总有效率为92.86%(39/42),高于对照组的76.19%(32/42),差异有统计学意义(P<0.05);治疗后,观察组SSA评分低于对照组,SWAL-QOL评分高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组吞咽时舌骨下肌群sEGM平均波幅及舌骨、甲状软骨上移、前移距离均大于对照组,吞咽时程短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为7.14%(3/42),低于对照组的23.81%(10/42),差异有统计学意义(P<0.05)。结论:神经肌肉电刺激联合舌肌训练治疗卒中后吞咽障碍患者效果显著,可提高吞咽功能和生命质量,改善吞咽肌群sEGM指标水平和舌骨喉复合体动度,降低并发症发生率,效果优于单用舌肌训练治疗。Objective:To observe effects of neuromuscular electrical stimulation combined with tongue muscle training on patients with swallowing dysfunction after stroke.Methods:The clinical data of 84 patients with swallowing dysfunction after stroke admitted to this hospital from May 2021 to July 2023 were retrospectively analyzed.According to different treatment plans,they were divided into control group and observation group,42 cases in each group.The control group was treated with tongue muscle training,while the observation group was treated with neuromuscular electrical stimulation on the basis of that of the control group.The clinical efficacy,the swallowing function[standardized swallowing assessment(SSA)]score,the quality of life[swallowing quality of life scale(SWAL-QOL)],the surface electromyography(sEGM)index levels of infrahyoid muscles during swallowing,and the hyoid-laryngeal complex mobility before and after treatment,and the incidence of complications were compared between the two groups.Results:The total effective rate of the observation group was 92.86%(39/42),which was higher than 76.19%(32/42)of the control group,and the difference was statistically significant(P<0.05).After treatment,the SSA score of the observation group was lower than that of the control group,the SWAL-QOL score was higher than that of the control group,and the differences were statistically significant(P<0.05).After the treatment,the average amplitude of sEGM in the infrahyoid muscles and the distance of hyoid bone and thyroid cartilage moving up and forward in the observation group were greater than those in the control group,the swallowing time was shorter than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 7.14%(3/42),which was lower than 23.81%(10/42)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Neuromuscular electrical stimulation combined with tongue muscle training is effective

关 键 词：卒中 吞咽障碍 神经肌肉电刺激 舌肌训练 舌骨喉复合体动度 

分 类 号：R493[医药卫生—康复医学]