神经肌肉电刺激对卒中后吞咽障碍治疗作用的研究

神经肌肉电刺激对卒中后吞咽障碍治疗作用的研究
李冰洁;张通;李芳
【期刊名称】《中国卒中杂志》
【年(卷),期】2017(012)003
【摘要】目的应用视频透视吞咽检查(video fluoroscopy swalowing
study,VFSS)方法从吞咽运动学变化方面研究神经肌肉电刺激(neuromuscular electrical stimulation,NMES)对卒中患者吞咽障碍的治疗作用.方法将卒中后吞咽障碍患者随机分为研究组和对照组,研究组给予NMES治疗,对照组给予假刺激,治疗均为每次20 min,5次/周,持续4周.同时所有患者均进行吞咽常规训练.治疗前后均行VFSS,获取3 ml液态钡食、10 ml液态钡食、半固体钡食及固体钡食4种食团吞咽的Rosenbek渗透-误吸量表(penetration-aspiration scale,PAS)评分、咽传递时间(pharyngeal transit time,PTT)、咽延迟时间(pharyngeal delayed time,PDT)、舌骨向前最大幅度、舌骨向上运动最大幅度、喉向前最大幅度及喉向上运动最大幅度.对比两组治疗前后PAS量表评分及上述吞咽运动学参数的变化.结果研究共纳入43例患者,其中研究组23例,对照组20例.治疗后,两组患者4种食团吞咽时PAS评分均较治疗前下降,PTT、PDT较治疗前缩短(均P<0.05).治疗前和治疗后,研究组在各食团吞咽时PAS评分及PTT、PDT较对照组差异均无显著性.治疗前,两组间舌骨向前、向上运动,喉向前、向上运动的最大幅度差异均无显著性;治疗后,研究组食团吞咽时舌骨向上运动、喉向上运动的最大幅度均较对照组显著增大(均P<0.05),但两组舌骨向前、喉向前运动差异无显著性.结论 NMES和常规吞咽康复训练均可改善卒中患者的吞咽功能.NMES更能提高喉-舌骨复合体的向上运动.%Objective To clarity the effects of neuromuscular electrical
stimulation (NMES) on swallowing function of post-stroke patients from kinematic research of swallowing by video fluoroscopy swallowing study (VFSS). Methods Patients with dysphagia were recruited and randomly allocated to the study group and the control group. VFSS was performed before treatments. Patients in the study group received real NMES, and patients in the control group received sham NMES. Different interventions were applied for 20 min per time, 5 times per week, for 4 weeks. All the patients received traditional swallowing therapy at the same time. The evaluation was performed by using VFSS before and after treatment. Rosenbek Penetration-Aspiration scale (PAS) of 3 ml liquid barium food, 10 ml liquid barium food, semisolid barium food and solid barium food, pharyngeal transit time (PTT), pharyngeal delayed time (PDT), maximal extent of forward laryngeal movement and upward laryngeal movement, maximal extent of forward hyoid movement and upward hyoid movement were obtained. The differences between two groups before and after treatment were identified respectively. Results A total of 43 patients were enrolled into study including 23 cases in study group and 20 cases in control group. After treatments, the scores of PAS of swallowing of 4 kinds of food in both groups were significantly reduced, and PDT and PTT were shorter compared with those before treatment (AllP<0.05). There were no significant differences between two groups in the scores of PAS, PTT and PDT before and after treatment. Before treatment, there was no signiifcance in difference in forward laryngeal movement, upward laryngeal movement, forward hyoid movement and upward hyoid
movement between two groups. After treatment, upward laryngeal movement and upward of hyoid movement of study group were significantly increased compared with those of the control group
(AllP<0.05), however, there were no significant differences in forward laryngeal movement and forward hyoid movement between two groups. Conclusion NMES and traditional swallowing therapy can improve the swallowing function of stroke patients. The application of NMES could improve the upward movement of hyolaryngeal complex better.
【总页数】7页(P207-213)
【作者】李冰洁;张通;李芳
【作者单位】100068 北京中国康复研究中心神经康复中心神经内科首都医科大学康复医学院博爱医院;100068 北京中国康复研究中心神经康复中心神经内科首都医科大学康复医学院博爱医院;100068 北京中国康复研究中心神经康复中心神经内科首都医科大学康复医学院博爱医院
【正文语种】中文
【相关文献】
1.神经肌肉电刺激治疗脑卒中后吞咽障碍的研究进展及启示 [J], 刘晟;孟宪梅
2.神经肌肉电刺激结合吞咽康复训练治疗脑卒中后吞咽障碍临床研究 [J], 刘冬凤
3.神经肌肉电刺激结合吞咽康复训练治疗脑卒中后吞咽障碍临床研究 [J], 刘冬凤
4.神经肌肉电刺激对卒中后吞咽障碍的治疗作用 [J], 王扬;周达岸
5.神经肌肉电刺激联合针刺治疗卒中后吞咽障碍的临床研究 [J], 吕学海;刘运平;叶秋桠;郭志娟;吕莹;段海丽;王立哲;赵玉芹
因版权原因，仅展示原文概要，查看原文内容请购买。