K点刺激辅助吞咽摄食训练在外伤性脑损伤中的应用  

Application of postoperative K-point stimulation assisted swallowing and feeding training in traumatic brain injury

作　　者：许珍珍 赵威 XU Zhenzhen;ZHAO Wei(Department of Surgery,Nanyang First People′s Hospital,Nanyang 473000,China;Department of Neurosurgery,the First Affiliated Hospital of Henan University of Science and Technology,Zhengzhou 450000,China)

机构地区：[1]南阳市第一人民医院手术部,南阳473000 [2]河南科技大学第一附属医院神经外科,郑州450000

出　　处：《华夏医学》2024年第5期114-119,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ2021021026)。

摘　　要：目的观察K点刺激辅助吞咽摄食训练对外伤性脑损伤术后吞咽困难的应用效果。方法选取90例外伤性脑损伤患者,按照随机数字表法分为训练组和联合组,每组45例。训练组实施吞咽摄食训练,联合组采用K点刺激辅助吞咽摄食训练,比较两组的颏下肌群表面肌电值,吞咽功能、营养状态及预后情况。结果在不同治疗方案下,联合组的空咽时颏下肌群最大振幅、平均振幅、吞咽时限均低于训练组,差异有统计学意义(P<0.05);联合组的标准吞咽功能量表(SSA)评分、反复唾液吞咽功能(RSST)评分均低于训练组(P<0.05);联合组的血清总蛋白(TP)、血清白蛋白(ALB)、血清转铁蛋白(TRF)均高于训练组(P<0.05);联合组的不良事件总发生率低于训练组(P<0.05)。结论K点刺激辅助吞咽摄食训练,能改善外伤性脑损伤术后吞咽困难患者的颏下肌群功能,对促进患者吞咽功能恢复,改善营养状态及预后情况均有积极意义。Objective To observe the effects of K-point stimulation assisted swallowing and feeding training on postoperative dysphagia in patients with traumatic brain injury.Methods 90 surgical patients with traumatic brain injury were randomly divided into the training group and combination group,with 45 patients in each group.The training group were implemented swallowing and feeding training,while the combined group were used K-point stimulation assisted swallowing and feeding training.The surface electromyographic values of the submandibular muscle group,swallowing function,nutritional status and prognosis were compared between two groups.Results Under different treatment regimens,the maximum amplitude,average amplitude,and swallowing time of the submandibular muscle group in the combined group were lower than those in the training group during empty swallowing,and difference was statistically significant(P<0.05).The standard swallowing function scale(SSA)score and recurrent salivary swallowing function(RSST)score of the joint group were lower than those of the training group(P<0.05).The total serum protein(TP),serum albumin(ALB),and serum transferrin(TRF)of the combined group were all higher than those of the training group(P<0.05).The incidence of adverse events in the combined group was lower than that in the training group(P<0.05).Conclusion K-point stimulation assisted swallowing and feeding training can improve the function of the submandibular in patients with postoperative dysphagia after traumatic brain injury,promote the recovery of swallowing function,improve nutritional status and prognosis,and is of positive significance.

关 键 词：K点刺激 吞咽摄食训练 外伤性脑损伤 吞咽功能 

分 类 号：R726.5[医药卫生—儿科]