Mendelsohn手法联合低频脉冲电刺激在缺血性脑卒中后吞咽障碍患者中的应用效果  

Application Effect of Mendelsohn Method Combined with Low Frequency Pulsed Electrical Stimulation in Patients with Dysphagia after Ischemic Stroke

作　　者：胡霞 王刚 邹怡 HU Xia;WANG Gang;ZOU Yi(Rehabilitation Department,Wujin Hospital of Traditional Chinese Medicine,Changzhou 213161,China)

机构地区：[1]武进中医医院康复科,江苏省常州市213161

出　　处：《实用心脑肺血管病杂志》2025年第6期114-118,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江苏省中医药管理局科技发展计划项目(MS2021033)。

摘　　要：目的探讨Mendelsohn手法联合低频脉冲电刺激在缺血性脑卒中后吞咽障碍患者中的应用效果。方法选取2019年7月—2024年5月武进中医医院收治的82例缺血性脑卒中后吞咽障碍患者为研究对象,采用信封法随机将患者分为Mendelsohn手法组40例和联合电刺激组42例。Mendelsohn手法组采取Mendelsohn手法治疗,联合电刺激组在Mendelsohn手法组的基础上联合低频脉冲电刺激治疗,治疗时间均为1个月。比较两组临床疗效,治疗前、治疗1个月后舌骨前移、上移距离及吞咽功能〔采用改良曼恩吞咽能力评估量表(MASA)、标准吞咽功能评定量表(SSA)、洼田饮水试验(KWST)评估〕、表面肌电图(sEMG)最大波幅、吞咽时程、容积-黏度吞咽测试(V-VST)分级,记录两组并发症发生情况。结果治疗后,联合电刺激组治疗总有效率高于Mendelsohn手法组(P<0.05)。治疗后,联合电刺激组舌骨前移、上移距离大于Mendelsohn手法组(P<0.05)。治疗后,联合电刺激组MASA评分高于Mendelsohn手法组,SSA、KWST评分低于Mendelsohn手法组(P<0.05)。治疗后,联合电刺激组sEMG最大波幅高于Mendelsohn手法组,吞咽时程短于Mendelsohn手法组(P<0.05)。治疗后,联合电刺激组V-VST分级优于Mendelsohn手法组(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论Mendelsohn手法联合低频脉冲电刺激可提高缺血性脑卒中后吞咽障碍患者的临床疗效及吞咽功能,增大舌骨前移、上移距离,改善V-VST分级,提高sEMG最大波幅,缩短吞咽时程,且无明显并发症。Objective To investigate the application effect of Mendelsohn method combined with low frequency pulsed electrical stimulation in patients with dysphagia after ischemic stroke.Methods A total of 82 patients with dysphagia after ischemic stroke admitted to Wujin Hospital of Traditional Chinese Medicine from July 2019 to May 2024 were selected as the research subjects,and the patients were divided into Mendelsohn method group(n=40)and combined electrical stimulation group(n=42)according to envelope method.Mendelsohn method group was treated with Mendelsohn method,while the combined electrical stimulation group was treated with low frequency pulsed electrical stimulation on the basis of Mendelsohn method group.The treatment time was 1 month for both groups.Clinical efficacy,distance of forward movement of hyoid bone,distance of upward movement of hyoid bone,swallowing function[evaluated by Mann Assessment of Swallowing Ability(MASA),Standardized Swallowing Assessment(SSA),Kubota's Water Swallowing Test(KWST)],surface electromyography(sEMG)maximum wave amplitude,swallowing duration,volume viscos-ity screening test(V-VST)grade before treatment and at 1 month after treatment were compared between the two groups,and the occurrence of complications in the two groups was recorded.Results After treatment,the total effective rate of the combined electrical stimulation group was higher than that of the Mendelsohn method group(P<0.05).After treatment,the distance of forward movement of hyoid bone and distance of upward movement of hyoid bone in the combined electrical stimulation group were greater than those in the Mendelsohn method group(P<0.05).After treatment,the MASA score in the combined electrical stimulation group was higher than that in the Mendelsohn method group,and the SSA score and KWST score in the combined electrical stimulation group were lower than those in the Mendelsohn method group(P<0.05).After treatment,the sEMG maximum wave amplitude in the combined electrical stimulation group was higher than that in t

关 键 词：缺血性卒中 吞咽障碍 Mendelsohn手法 低频脉冲电刺激 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]