高频rTMS联合吞咽-摄食训练对脑卒中吞咽障碍患者EAT-10评分、吞咽安全性的影响  

Effects of high-frequency rTMS combined with swallowing and feeding training on EAT-10 score and swallowing safety in stroke patients with swallowing disorder

作　　者：赵啟帆 桂晓彤 徐晨曦 严雅琪 杨婷[1] 卜玲玲[1] 徐梅 ZHAO Qifan;GUI Xiaotong;XU Chenxi;YAN Yaqi;YANG Ting;BU Lingling;XU Mei(Department of Rehabilitation Medicine,Nanjing Hospital Affiliated to Nanjing Medical University/Nanjing First Hospital,Nanjing,Jiangsu,210012,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院康复医学科,江苏南京210012

出　　处：《中华神经外科疾病研究杂志》2025年第1期53-58,共6页Chinese Journal of Neurosurgical Disease Research

基　　金：南京市卫生科技发展专项项目(YKK20106)。

摘　　要：目的探讨高频重复经颅磁刺激(rTMS)联合吞咽-摄食训练对脑卒中吞咽障碍(PSD)患者进食评估问卷调查工具(EAT-10)评分、吞咽安全性的影响。方法按随机数字表法将2021年2月至2024年2月南京医科大学附属南京医院康复医学科收治的120例PSD患者分为单一组(n=60)和联合组(n=60),单一组实施吞咽-摄食训练干预,联合组实施高频rTMS联合吞咽-摄食训练干预。比较两组临床疗效、吞咽功能[吞咽功能评价量表(SSA)评分、EAT-10评分]、吞咽安全性[改良曼恩吞咽能力评估量表(MMASA)、渗透误吸量表(PAS)]及吞咽造影评估结果[吞咽造影检查(VFSS)]。结果联合组治疗总有效率高于单一组(91.67%vs 78.33%)(P<0.05)。治疗后,两组SSA评分、EAT-10评分均降低,且联合组低于单一组(P<0.05)。治疗后,两组MMASA评分均升高,且联合组高于单一组,两组PAS评分均降低,且联合组低于单一组(均P<0.05)。治疗后,两组口腔运送、吞咽反应、咽运送及喉关闭时间均降低,且联合组口腔运送、吞咽反应、咽运送时间低于单一组(P<0.05),但两组喉关闭时间比较差异无统计学意义(P>0.05)。结论高频rTMS联合吞咽-摄食训练治疗PSD患者具有较好的疗效,可以显著改善患者吞咽功能,缩短吞咽时间,并提高吞咽安全性。Objective To explore the effects of high-frequency repetitive transcranial magnetic stimulation(rTMS)combined with swallowing and feeding training on the scores of the Eating Assessment Questionnaire Tool(EAT-10)and swallowing safety in stroke patients with swallowing disorders(PSD).Methods According to the random number table method,120 PSD patients admitted to the Rehabilitation Medicine Department of Nanjing Hospital Affiliated to Nanjing Medical University from February 2021 to February 2024 were divided into a single group(P=60)and a combination group(n=60).The single group received swallowing and feeding training intervention,whereas the combination group received high-frequency rTMS combined with swallowing and feeding training intervention.The clinical efficacy,swallowing function[Swallowing Function Assessment Scale(SSA)score,EAT-10 score],swallowing safety[Modified Mann Swallowing Ability Assessment Scale(MMASA),Permeation Aspiration Scale(PAS)],and swallowing contrast imaging evaluation results[Swallowing Contrast Imaging(VFSS)]between these two groups of patients were compared and analyzed.Results The total effective rate of the combined treatment group was higher than that of the single group(91.67%vs 78.33%)(P<0.05).After treatment,the SSA score and EAT-10 score of both groups decreased,with the combined group being lower(P<0.05).After treatment,WST score and PAS score decreased in both groups,with the combined group being lower(P<0.05).After treatment,the MMASA scores of both groups of patients increased,with the combined group being higher..After treatment,both groups showed a decrease in oral transport,swallowing reaction,pharyngeal transport,and laryngeal closure time,with the combined group having lower oral transport,swallowing reaction,and pharyngeal transport time(P<0.05).There was no statistically significant difference in laryngeal closure time between the two groups(P>0.05).Conclusions High frequency rTMS combined with swallowing and feeding training has shown good efficacy in the treatme

关 键 词：重复经颅磁刺激 吞咽-摄食训练 脑卒中 吞咽障碍 进食评估问卷调查工具 

分 类 号：R743.3[医药卫生—神经病学与精神病学]