情景互动呼吸训练联合高频重复经颅磁刺激治疗脑梗死后吞咽障碍的效果观察  

Observation on the Therapeutic Effect of Scenario-based Interactive Breathing Training Combined with High-frequency Repetitive Transcranial Magnetic Stimulation on Swallowing Disorders after Cerebral Infarction

作　　者：王笑 魏冰 董晓莹 薛翠萍 代欣 万桂玲 WANG Xiao;WEI Bing;DONG Xiaoying;XUE Cuiping;DAI Xin;WAN Guiling(Speech Swallowing and Voice Rehabilitation Center,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China;Rehabilitation Diagnosis and Treatment Center,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China;Neurorehabilitation Center,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院言语吞咽嗓音康复中心,北京100144 [2]首都医科大学附属北京康复医院康复诊疗中心,北京100144 [3]首都医科大学附属北京康复医院神经康复中心,北京100144

出　　处：《临床误诊误治》2025年第1期80-84,共5页Clinical Misdiagnosis & Mistherapy

基　　金：首都医科大学附属北京康复医院康复临床研究培育专项青年项目(2021-032)。

摘　　要：目的观察情景互动呼吸训练联合高频重复经颅磁刺激(rTMS)治疗脑梗死(CI)后吞咽障碍的效果。方法选取2021年6月至2023年6月治疗的84例老年CI后吞咽障碍患者。随机数字表法分为2组,对照组42例采用高频rTMS治疗,观察组42例采用情景互动呼吸训练联合高频rTMS治疗。对比2组基线资料、疗效以及治疗前后吞咽功能改善程度。结果2组基线资料比较无统计学差异(P>0.05)。误吸程度评分、吞咽困难评分、洼田饮水试验分级比较,观察组治疗后低于对照组,功能性摄食量表评分以及表面肌电图域指标-均方根高于对照组(P<0.05)。食管上括约肌开放时长及开放程度、咽收缩持续时长比较,观察组治疗后高于对照组(P<0.05)。观察组总有效率92.86%(39/42)与对照组85.71%(36/42)比较无统计学差异(P>0.05)。结论情景互动呼吸训练联合高频rTMS康复治疗能有效提高CI后吞咽障碍患者的吞咽功能,对患者病情好转具有重要意义。Objective To observe the effect of scenario-based interactive breathing training combined with high-frequency repetitive transcranial magnetic stimulation(rTMS)on swallowing dysfunction after cerebral infarction(CI).Methods A total of 84 elderly patients with swallowing disorders after CI treated from June 2021 to June 2023 were selected.Using the random number table method,they were divided into two groups.The control group(n=42)received high-frequency rTMS,while the observation group(n=42)received scenario-based interactive breathing training combined with high-frequency rTMS.Baseline data,efficacy,and improvement in swallowing function before and after treatment were compared between two groups.Results There was no significant difference in baseline data between the two groups(P>0.05).After treatment,degree of aspiration score,the swallowing difficulty score,and Wadian drinking water test grading of the observation group were lower than those in the control group,while the functional food intake scale score and surface electromyography domain index-root mean square were higher than those in the control group(P<0.05).After treatment,the observation group showed obvious longer duration and greater degree of esophageal sphincter opening,and duration of pharyngeal contraction,as compared with the control group(P<0.05).The total effective rate was 92.86%(39/42)in the observation group and 85.71%(36/42)in the control group,suggesting no significant difference(P>0.05).Conclusion The combination of scenario-based interactive breathing training and high-frequency rTMS rehabilitation therapy can effectively improve the swallowing function of patients after CI,which have significant implications for the improvement of their condition.

关 键 词：脑梗死 吞咽障碍 情景互动呼吸训练 重复经颅磁刺激 康复 误吸 表面肌电图 

分 类 号：R743.33[医药卫生—神经病学与精神病学]