舌骨上肌群下颏抗阻力训练联合神经肌肉电刺激对老年口咽期吞咽障碍患者吞咽功能的影响  

Effect of Chin Tuck against Resistance Exercise for Suprahyoid Muscle Group Combined with Neuromuscular Electrical Stimulation on Swallowing Function in Elderly Patients with Oropharyngeal Dysphagia

作　　者：江秀娟 徐艳[1] 危正林 唐协林[2] JIANG Xiujuan;XU Yan;WEI Zhenglin;TANG Xielin(Department of Geriatrics,Santai Hospital Affiliated to North Sichuan Medical College,Santai,Sichuan 621100,China;Department of Neurosurgery,Santai Hospital Affiliated to North Sichuan Medical College,Santai,Sichuan 621100,China)

机构地区：[1]川北医学院附属三台医院老年医学科,四川三台621100 [2]川北医学院附属三台医院神经外科,四川三台621100

出　　处：《临床误诊误治》2025年第5期32-36,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2022年四川省医学(青年创新)科研课题(S22078);绵阳市卫健委2019年科研课题鼓励项目(201956);三台县人民医院院级科研课题(2022YN03)。

摘　　要：目的探究舌骨上肌群下颏抗阻力训练(CTAR)联合神经肌肉电刺激(NMES)对老年口咽期吞咽障碍(OD)患者吞咽功能的影响。方法将2022年2月至2023年1月收治的43例老年OD患者纳入对照组,行NMES治疗,另将2023年2月至2023年12月收治的43例老年OD患者纳入观察组,在对照组基础上行舌骨上肌群CTAR治疗,均连续治疗4周。比较2组临床疗效,治疗前后2组吞咽功能、营养状况[白蛋白、血红蛋白和上臂肌围(MAMC)]、日常生活能力和躯体功能。结果观察组治疗总有效率为97.67%(42/43)高于对照组的83.72%(36/43),差异有统计学意义(P<0.05)。治疗后,2组口腔准备、吞咽过程、吞咽后表现评分均降低,且观察组均低于对照组(P<0.05,P<0.01)。治疗后,2组血红蛋白、白蛋白、MAMC均升高,且观察组高于对照组(P<0.05,P<0.01)。2组日常生活活动能力量表评分、肌肉力量、步速均升高,且观察组高于对照组(P<0.05,P<0.01)。结论舌骨上肌群CTAR联合NMES治疗老年OD效果显著,能有效改善患者的吞咽功能、营养状况,促进日常生活能力和躯体功能提升。Objective To investigate the effects of chin tuck against resistance(CTAR)exercise for suprahyoid muscle group combined with neuromuscular electrical stimulation(NMES)on swallowing function in elderly patients with oropharyngeal dysphagia(OD).Methods Forty-three elderly OD patients admitted from February 2022 to January 2023 were included in the control group and treated with NMES.Another 43 elderly OD patients admitted from February 2023 to December 2023 were included in the observation group and treated with CTAR for suprahyoid muscle group on the basis of the control group.Both groups were treated for 4 consecutive weeks.The clinical efficacy,swallowing function,nutritional status[albumin(ALB),hemoglobin(Hb)and mild arm muscle circumference(MAMC)],activities of daily living(ADL)and physical function of the two groups were compared before and after treatment.Results The total effective rate of the observation group was 97.67%(42/43),which was higher than that of the control group[83.72%(36/43)],suggesting significant difference(P<0.05).After treatment,the scores of oral preparation,swallowing process and post-swallowing performance were decreased in the two groups,which were lower in the observation group than in the control group(P<0.05,P<0.01).After treatment,hemoglobin,albumin,and MAMC in both groups were increased,which were higher in the observation group than in the control group(P<0.05,P<0.01).The scores of ADL scale,muscle strength and walking speed were all increased in the two groups,which were higher in the observation group than in the control group(P<0.05,P<0.01).Conclusion CTAR for suprahyoid muscle group combined with NMES is effective in the treatment of OD in elderly patients,which can effectively improve the swallowing function and nutritional status of patients,and promote the ADL and physical function.

关 键 词：口咽期吞咽障碍 老年人 舌骨上肌群下颏抗阻力训练 神经肌肉电刺激 吞咽功能 上臂肌围 日常生活能力 肌肉力量 

分 类 号：R493[医药卫生—康复医学]