咽腔低频电刺激联合吞咽镜像视觉反馈训练在急性脑卒中后吞咽障碍中的应用效果  

Effect of low-frequency pharyngeal electrical stimulation combined with swallowing mirror visual feedback training in treating post-acute stroke dysphagia

作　　者：卢芸 边贝贝 LU Yun;BIAN Beibei(Department of Rehabilitation Medicine,the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450016,China)

机构地区：[1]郑州市第七人民医院康复医学科,郑州450016

出　　处：《上海医药》2025年第2期54-58,共5页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:观察咽腔低频电刺激联合吞咽镜像视觉反馈训练在急性脑卒中后吞咽障碍中的应用效果。方法:采用随机对照设计,纳入240例患者分为观察组(116例完成)和对照组(115例完成),分别接受联合疗法和单纯视觉反馈训练,疗程4周。对比2组的临床疗效、吞咽造影检查(VFSS)/功能性经口摄食量表(FOIS)/吞咽障碍结局与严重度量表(DOSS)评分、表面肌电图、血清中相关因子(GFAP、EGR1)水平变化、并发症发生率。结果:观察组总有效率高于对照组(94.83%vs86.96%)。治疗后,观察组VFSS/FOIS/DOSS评分及肌电波幅均显著提升,吞咽时程缩短,GFAP、EGR1水平及并发症发生率显著降低(均P<0.05)。结论:咽腔低频电刺激联合吞咽镜像视觉反馈训练更利于改善急性脑卒中后吞咽障碍患者的吞咽功能、增强吞咽相关肌群肌力,促进康复。Objective:To evaluate the efficacy of low-frequency pharyngeal electrical stimulation combined with swallowing mirror visual feedback training in treating post-acute stroke dysphagia.Methods:Two hundred and forty cases of patients were enrolled and divided into an observation group(116 completed)and a control group(115 completed)based on a randomized controlled trial.The observation group received a combined therapy,while the control group underwent visual feedback training alone,and the treatment was lasted for 4 weeks.Outcomes included clinical efficacy,video fluoroscopy swallowing study(VFSS),functional oral intake scale(FOIS),dysphagia outcome and severity scale(DOSS)scores,surface electromyography parameters,serum biomarker levels(GFAP,EGR1),and complication rates.Results:The observation group showed higher total efficacy(94.83%vs 86.96%,P<0.05)and more significant improvement in VFSS,FOIS,DOSS scores and electromyographic amplitude,shorter swallowing duration,lower serum glial fibrillary acidic protein(GFAP)and early growth response factor 1(EGR1)levels and complication rates(all P<0.05).Conclusion:The combined therapy demonstrates superior efficacy in improving swallowing function,enhancing swallowing-related muscle strength,and can promote the recovery of patients with post-acute stroke dysphagia.

关 键 词：脑卒中 吞咽障碍 咽腔低频电刺激 吞咽镜像视觉反馈训练 

分 类 号：R454.1[医药卫生—治疗学] R743.3[医药卫生—临床医学]