神经肌肉电刺激联合针刺及舌压抗阻反馈训练对脑卒中后吞咽障碍患者的康复效果  

Rehabilitation Effect of Neuromuscular Electrical Stimulation Combined with Acupuncture and Tongue Pressure Resistance Feedback Training on Patients with Deglutition Disorders after Stroke

作　　者：周磊 毕传昊 张芳芳 王辰之 ZHOU Lei;BI Chuanhao;ZHANG Fangfang;WANG Chenzhi(Rehabilitation Acupuncture Department,the Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University,Huaian 223000,China)

机构地区：[1]南京医科大学附属淮安第一医院康复针灸科,江苏省淮安市223000

出　　处：《实用心脑肺血管病杂志》2025年第4期98-102,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江苏省科技厅基础研究计划(自然科学基金)项目(BK20211493)。

摘　　要：目的 观察神经肌肉电刺激联合针刺及舌压抗阻反馈训练对脑卒中后吞咽障碍患者的康复效果。方法选取2022年6月—2024年6月南京医科大学附属淮安第一医院收治的126例脑卒中后吞咽障碍患者作为研究对象,采用随机数字表法将患者分为对照组63例和观察组63例。对照组患者接受神经肌肉电刺激联合针刺治疗,观察组患者在对照组基础上接受舌压抗阻反馈训练。两组患者均持续治疗3周。比较两组临床疗效,治疗前及治疗3周后渗漏-误吸、梨状窝残留发生情况及标准吞咽功能评估量表(SSA)评分,甲状软骨及舌骨上移、前移距离,表面肌电图指标(吞咽耗时、肌电最大波幅),并观察两组治疗期间不良事件发生情况。结果 观察组临床疗效优于对照组(P<0.05)。治疗3周后,观察组渗漏-误吸、梨状窝残留发生率及SSA评分低于对照组(P<0.05)。治疗3周后,观察组甲状软骨及舌骨上移、前移距离大于对照组(P<0.05)。治疗3周后,观察组吞咽耗时短于对照组,肌电最大波幅大于对照组(P<0.05)。两组治疗期间均未见不良事件发生。结论 神经肌肉电刺激联合针刺及舌压抗阻反馈训练治疗脑卒中后吞咽障碍的疗效确切,可有效提高患者舌骨运动能力及吞咽肌群力量,进而改善患者的吞咽功能,减少渗漏-误吸、梨状窝残留发生,且安全性较高。Objective To observe the rehabilitation effect of neuromuscular electrical stimulation combined with acupuncture and tongue pressure resistance feedback training on patients with deglutition disorders after stroke.Methods A total of 126 patients with deglutition disorders after stroke admitted to the Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University from June 2022 to June 2024 were selected as the research subjects.The patients were divided into the control group and the observation group according to random number table method,63 cases in each group.Patients in the control group received neuromuscular electrical stimulation combined with acupuncture,while patients in the observation group received tongue pressure resistance feedback training based on the control group.Both groups of patients received continuous treatment for 3 weeks.Clinical efficacy,incidence of leakage-aspiration,incidence of residual pyriform fossa,Standardized Swallowing Assessment(SSA)score,moving up and forward distance of thyroid cartilage and hyoid bone,and surface electromyographic indicators(swallowing time,maximum electromyographic amplitude)were compared between the two groups before treatment and after 3 weeks of treatment,and incidence of adverse events during treatment was observed of the two groups.Results The clinical efficacy of the observation group was better than that of the control group(P<0.05).After 3 weeks of treatment,the incidence of leakage-aspiration and residual pyriform fossa,and SSA score in the observation group were lower than those in the control group(P<0.05).After 3 weeks of treatment,moving up and forward distance of thyroid cartilage and hyoid bone in the observation group were greater than those in the control group(P<0.05).After 3 weeks of treatment,swallowing time of the observation group was shorter than that in the control group,and maximum electromyographic amplitude was greater than that of the control group(P<0.05).During treatment,neither group experienced any adverse events.Co

关 键 词：卒中 吞咽障碍 神经肌肉电刺激 针刺 舌压抗阻反馈训练 

分 类 号：R743[医药卫生—神经病学与精神病学] R571[医药卫生—临床医学]