肌电生物反馈强化训练联合口唇操训练对脑卒中后吞咽障碍患者吞咽功能及营养状况的影响  

Impact of Electromyographic Biofeedback Intensive Training Combined with Lip Exercise Training on Swallowing Function and Nutritional Status of Patients with Post-Stroke Dysphagia

作　　者：李君[1] 樊春晖[1] 乔盼盼[1] 桂飞飞 LI Jun;FAN Chunhui;QIAO Panpan;GUI Feifei(Department of Rehabilitation Medicine,the First Affiliated Hospital of He'nan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院康复医学科,河南开封475000

出　　处：《临床医学工程》2025年第3期269-273,共5页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20210558)。

摘　　要：目的 探讨肌电生物反馈强化训练联合口唇操训练在脑卒中后吞咽障碍(PSD)患者中的应用效果。方法 选取我院2022年12月至2024年8月收治的103例PSD患者,随机分为两组。在脑卒中常规治疗基础上,对照组给予口唇操训练,观察组给予肌电生物反馈强化训练联合口唇操训练。比较两组的洼田饮水试验(WST)分级、食管上括约肌(UES)开放状态、标准吞咽功能评定量表(SSA)评分、 Rosenbek渗漏-误吸(PAS)评分、舌骨上肌群肌电(i EMG)积分、营养状况、吞咽相关生活质量量表(SWAL-QOL)评分。结果 治疗后,观察组的WST分级明显优于对照组(P <0.05)。治疗后,两组的UES开放状态均较治疗前明显改善,且观察组的UES开放状态明显优于对照组(P <0.05)。治疗后,两组的SSA、 PAS评分均明显低于治疗前,i EMG值均明显高于治疗前(P <0.05);观察组的SSA、 PAS评分均明显低于对照组,i EMG值明显高于对照组(P <0.05)。治疗后,两组的ALB、 PA水平均明显高于治疗前,且观察组的ALB、 PA水平均明显高于对照组(P <0.05);两组的AMC、 TSF比较,差异无统计学意义(P>0.05)。治疗后,两组的SWAL-QOL评分均明显高于治疗前,且观察组的SWAL-QOL评分明显高于对照组(P <0.05)。结论 肌电生物反馈强化训练联合口唇操训练能够显著改善PSD患者的吞咽功能及营养状态,提高其生活质量。Objective To explore the application effect of electromyographic biofeedback intensive training combined with lip exercise training in patients with post-stroke dysphagia(PSD).Methods 103 PSD patients admitted to our hospital from December 2022 to August 2024 were selected and randomly divided into two groups.On the basis of routine treatment for stroke,the control group received lip exercise training,and the observation group received electromyographic biofeedback intensive training combined with lip exercise training.The Wada water swallow test(WST)grading,upper esophageal sphincter(UES)open status,standard swallowing function assessment(SSA)score,Rosenbek penetration-aspiration scale(PAS)score,integrated electromyography of the suprahyoid muscles(iEMG)score,nutritional status,and swallowing related quality of life(SWAL-QOL)score were compared between two groups.Results After treatment,the WST grading in the observation group was significantly better than that in the control group(P<0.05).After treatment,the open status of UES in both groups improved significantly compared to that before treatment,and the open status of UES in the observation group was significantly better than that in the control group(P<0.05).After treatment,the SSA and PAS scores of both groups were significantly lower than those before treatment, and the iEMG values were significantly higher than those before treatment (P <0.05);TheSSA and PAS scores in the observation group were significantly lower than those in the control group, and the iEMG value was significantlyhigher than that in the control group (P <0.05). After treatment, the levels of ALB and PA in both groups were significantly higher than thosebefore treatment, and the levels of ALB and PA in the observation group were significantly higher than those in the control group (P <0.05);No statistically significant difference was found in the AMC and TSF between the two groups (P >0.05). After treatment, the SWAL-QOLscores of both groups were significantly higher than those before tr

关 键 词：肌电生物反馈强化训练 口唇操训练 脑卒中后吞咽障碍 吞咽功能 营养状况 生活质量 

分 类 号：R493[医药卫生—康复医学]