颈前筋膜针刀松解术治疗脑卒中后吞咽功能障碍的临床效果  

Clinical Effect of Anterior Cervical Fascia Needle Knife Relaxation in the Treatment of Swallowing Dysfunction after Stroke

作　　者：陈梁 陆新燕 陆银艳 靳康 邓少果 钟志年 CHEN Liang;LU Xinyan;JIN Kang;DENG Shaoguo;ZHONG Zhinian(Department of Rehabilitation Medicine,Qinzhou Hospital of Traditional Chinese Medicine,Guangxi Qinzhou 535009)

机构地区：[1]钦州市中医医院康复医学(疼痛)科,广西钦州535000

出　　处：《深圳中西医结合杂志》2024年第22期1-4,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广西中医药适宜技术开发与推广项目(GZSY21-90);钦州市科学研究与技术开发计划项目(20202738)。

摘　　要：目的:浅析脑卒中后吞咽功能障碍使用颈前筋膜针刀松懈术治疗的临床效果。方法:选取钦州市中医医院康复医学科2021年1月至2022年3月收治的脑卒中后吞咽功能障碍患者60例,根据随机数表法分为对照组与观察组,各30例。对照组患者接受常规吞咽训练治疗,观察组患者在对照组的基础上开展颈前筋膜针刀松懈术治疗。比较两组患者治疗前后表面肌电图、吞咽功能、洼田饮水试验评分(WST)、大脑动脉血流动力学指标。结果:治疗后观察组患者标准吞咽功能评估量表(SSA)、洼田饮水试验评分(WST)评分低于对照组,差异具有统计学意义(P<0.05);治疗后观察组患者表面肌电图最大波幅高于对照组,吞咽时间短于对照组,差异具有统计学意义(P<0.05);治疗后观察组患者脑血流动力学最大峰值流速(Vs)、平均流速(Vm)高于对照组,阻力指数(RI)低于对照组,差异具有统计学意义(P<0.05)。结论:对于脑卒中后吞咽功能障碍患者,应用颈前筋膜针刀松懈术,可有效改善吞咽功能,改善脑血流动力学指标,提升舌部肌肉运动能力。Objective To analyze the clinical effect of anterior cervical fascial needle knife relaxation in the treatment of dysphagia dysfunction after stroke.Methods A total of 60 stroke patients admitted to Department of Rehabilitation Medicine,Qinzhou Hospital of Traditional Chinese Medicine from January 2021 to March 2022 were selected and divided into a control group and an observation group according to random number table method,with 30 cases in each group.Patients in the control group received routine swallowing training treatment,and patients in the observation group were treated with anterior cervical fascia needle knife relaxation on the basis of the control group.The surface electromyography,swallowing function,water swallow test(WST)and cerebral arterial hemodynamics were compared between the two groups before and after treatment.Results After treatment,the scores of standard swallowing sunction assessment scale(SSA)and WST of the observation group were lower than those of the control group,with statistical significances(P<0.05).After treatment,the maximum amplitude of surface electromyogram in the observation group was higher than that in the control group,and the swallowing time was shorter than that in the control group,the differences were statistically significant(P<0.05).After treatment,the maximum peak flow velocity(Vs)and average flow velocity(Vm)of cerebral hemodynamics in the observation group were higher than those in the control group,and the resistance index(RI)was lower than that in the control group,with statistical significances(P<0.05).Conclusion For the patients with swallowing dysfunction after stroke,the use of anterior cervical fascia needle knife relaxation can effectively improve the swallowing function,improve cerebral hemodynamics indexes,and enhance the tongue muscle movement ability.

关 键 词：脑卒中 颈前筋膜针刀松懈术 咽反射训练 发声运动 

分 类 号：R743.3[医药卫生—神经病学与精神病学]