肌电生物反馈疗法联合神经肌肉电刺激对脑卒中后吞咽障碍患者吞咽功能及营养状况的影响

摘要

Objective:To study the effect of electromyographic biofeedback training combined with neuromuscular electric stimulation (NMES)on swallowing function and nutritional status after stroke.Methods:Sixty patients with dysphagia following stroke were divided randomly into three groups:the conventional group (20 cases)treated with swallowing function training;the NMES group (20 cases),and the integrated group (20 cases)treated with electromyographic biofeedback training and NMES.The iEMG of suprahyoid muscles was collected,and nutrition indexes were measured before and one month after treatment.The gastric retention rate was recorded.Results:The iEMG of suprahyoid muscles and nutrition indexes in three groups were significantly improved after treatment as compared with those pre-treatment (P <0.05),more significantly in the integrated group than other groups (P <0.05).The gastric retention rate in three groups was decreased significantly one month after treatment as compared with that pre-treatment (P <0.05),and there was no statistically significant difference among the three groups after treatment (P >0.05).Conclusions:Combined therapy of electromyographic biofeedback training with NMES is ef-fective to improve the swallowing function and nutritional status of patients with dysphagia following stroke.%目的：：探讨肌电生物反馈疗法联合神经肌肉电刺激(NMES)对脑卒中吞咽障碍患者吞咽功能及营养状况的影响。方法：60例脑卒中吞咽障碍患者随机分为常规组、NMES 组、综合组各20例，常规组接受吞咽功能训练， NMES 组接受神经肌肉电刺激，综合组接受肌电生物反馈治疗和神经肌肉电刺激。分别于治疗前及治疗1个月后采集3组患者的舌骨上肌群肌电积分值，进行营养指标测量，同时记录治疗前后3组患者胃管留置率的变化情况。结果：3组患者治疗后舌骨上肌群肌电积分值及各项营养指标均较治疗前改善(P <0.05)，治疗后综合组的改善幅度更优于 NMES 组和常规组(P <0.05)。3组患者治疗后的胃管留置率均较治疗前有明显下降(P <0.05)，但3组间比较差异无统计学意义。结论：脑卒中吞咽障碍患者在神经肌肉电刺激基础上辅以肌电生物反馈治疗可以明显改善其吞咽功能及营养状况。