重复经颅磁刺激联合吞咽训练在脑梗死后吞咽障碍患者康复中的应用效果  

Application effect of repetitive transcranial magnetic stimulation combined with swallowing training in rehabilitation of patients with swallowing disorders after cerebral infarction

作　　者：陈艳玮 皮睿[1] 冯亚琼 CHEN Yanwei;PI Rui;FENG Yaqiong(Department of Neurological Rehabilitation,Zhengzhou Central Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市中心医院神经康复科,河南郑州450000

出　　处：《现代医药卫生》2025年第4期931-934,939,共5页Journal of Modern Medicine & Health

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合吞咽训练对脑梗死后吞咽障碍患者的康复效果。方法选取2021年3月至2024年3月该院80例脑梗死后吞咽障碍患者进行前瞻性研究,采用随机数字表法分为2组,每组40例,对照组采用吞咽训练,观察组在对照组的基础上联合rTMS干预,2组均干预4周。比较2组干预前、干预2周、干预4周时吞咽功能[吞咽功能评价量表(SSA)]、洼田饮水试验(WST)分级情况、生活质量[吞咽障碍特异性生活质量量表(SWAL-QOL)]评分及干预4周时误吸和吸入性肺炎发生率。结果干预后,2组SSA评分均低于干预前,且观察组低于对照组(P<0.05);观察组WST分级1、2级占比高于对照组(P<0.05);2组SWAL-QOL评分均高于干预前,且观察组高于对照组(P<0.05);干预4周时,观察组误吸发生率低于对照组[5.0%(2/40)vs.22.5%(9/40)],差异有统计学意义(χ^(2)=5.165,P<0.05);2组吸入性肺炎发生率比较,差异无统计学意义(P>0.05)。结论rTMS联合吞咽训练可加快脑梗死后吞咽障碍患者吞咽功能恢复进度,提高生活质量,减少误吸,效果优于单纯吞咽训练。Objective To explore the application effect of repetitive transcranial magnetic stimulation(rTMS)combined with swallowing training in the rehabilitation of patients with swallowing disorders after cerebral infarction.Methods A prospective study was conducted on 80 patients with swallowing disorders after cerebral infarction in the hospital from March 2021 to March 2024.They were randomly divided into two groups,40 cases in each group.The control group received swallowing training,while the observation group received rTMS intervention in addition to the control group.Both groups were intervened for 4 weeks.The swallowing function[swallowing function assessment scale(SSA)],Kubota drinking water test(WST)grading,quality of life[swallowing disorder specific quality of life scale(SWAL-QOL)]score,at before the intervention,2 weeks and 4 weeks after the intervertion,and incidence of aspiration and aspiration pneumonia at 4 weeks after the intervention were compared between the two groups.Results After intervention,SSA scores in both groups were lower than those before intervention,and observation group was lower than that control group(P<0.05).The proportion of WST grades 1 and 2 in observation group was higher than that in control group(P<0.05);SWAL-QOL scores in 2 groups were higher than those before intervention,and observation group was higher than control group(P<0.05).After 4 weeks of intervention,the incidence of aspiration in observation group was lower than that in control group[5.0%(2/40)vs.22.5%(9/40)],and the difference was statistically significant(χ^(2)=5.165,P<0.05).There was no significant difference in the incidence of aspiration pneumonia between 2 groups(P>0.05).Conclusion The combination of rTMS and swallowing training can accelerate the recovery of swallowing function in patients with swallowing disorders after cerebral infarction,improve their quality of life,reduce aspiration,and has better effects than simple swallowing training.

关 键 词：脑梗死 吞咽障碍 重复经颅磁刺激 吞咽训练 生活质量 

分 类 号：R473[医药卫生—护理学]