神经肌肉电刺激结合吞咽训练治疗脑卒中后吞咽障碍疗效观察

摘要

目的:探讨神经肌肉电刺激结合吞咽训练在脑卒中后吞咽障碍中的运用.方法:选择86例恢复期脑卒中患者,按照数字表法随机分为单纯训练组和联合训练组,每组43例.单纯训练组接受吞咽训练,联合训练组接受吞咽训练的同时配合神经肌肉电刺激训练,两组患者其他康复治疗方法及护理方法均完全相同.比较两组患者治疗效果及治疗前后视频荧光成像法(VFG)和吞咽生活质量量表(SWAL-QQL)评分变化.结果:治疗后,联合训练组总有效率明显高于单纯训练组(95.35%比69.77%,P=0.006).与单纯训练组比较,联合训练组治疗后VFG评分[(5.74±1.86)分比(6.88±2.32)分]明显提高,SWAL-QOL[(762.66±27.22)分比(648.22±29.62)分]评分明显减少(P=0.025, 0.001).结论:神经肌肉电刺激结合吞咽训练比单独的吞咽训练效果更好,更有利于吞咽功能恢复.%Objective:To explore therapeutic effect of neuromuscular electrical stimulation combined swallowing training in dysphagia after stroke.Methods: A total of 86 stroke patients during recovery period were selected.According to random number table, they were randomly and equally divided into pure training group (received swallowing training based on rehabilitation treatment and nursing care) and combined training group (received neuromuscular electrical stimulation based on routine training group).Therapeutic effects, scores of video fluorography (VFG) and swallowing quality of life (SWAL-QOL) questionnaire before and after treatment were compared between two groups.Results: After treatment, total effective rate of combined training group was significantly higher than that of pure training group (95.35% vs.69.77%, P=0.006).Compared with pure training group after treatment, there was significant rise in VFG score [(5.74±1.86) scores vs.(6.88±2.32) scores], and significant reduction in SWAL-QOL score [(762.66±27.22) scores vs.(648.22±29.62) scores] in combined training group, P=0.025, 0.001 respectively.Conclusion: Compared with swallowing training alone, neuromuscular electrical stimulation combined swallowing training possesses better therapeutic effects, which is better for recovery of swallowing function.