摘要
目的探讨以深层咽肌神经刺激疗法(DPNS)为主的康复治疗对脑卒中后吞咽障碍的影响。方法选择2013年1月至2015年12月海安县人民医院康复科收治的70例脑卒中后吞咽障碍患者作为研究对象,按照随机数字法分为观察组和对照组,各35例。对照组在常规脑卒中药物治疗的基础上,进行康复训练治疗;观察组在对照组的基础上给予双边软腭平滑、三边软腭、舌后根、舍旁、舌中央、双边咽喉壁紧缩反射、舌后根回缩反射力量和小舌头/悬雍垂刺激等DPNS为主的康复治疗,1周为1个疗程,共治疗3个疗程。治疗后,观察两组患者的洼田饮水试验评分、标准吞咽功能评分(SSA)、X线吞咽造影检查(VFSS)评分、吸入性肺炎率、营养不良率等的变化情况。结果治疗后,观察组的洼田饮水试验、SSA评分低于治疗前,VFSS评分高于治疗前;且观察组的洼田饮水试验、SSA评分低于对照组[(2.61±0.23)分比(3.54±0.37)分,(24.90±3.36)分比(28.80±3.42)分],VFSS评分高于对照组[(7.58±0.64)分比(6.04±0.59)分](P<0.01)。治疗后,观察组的吸入性肺炎和营养不良发生率均低于对照组[8.57%(3/35)比20.00%(7/35),11.43%(4/35)比25.71%(9/35)](P<0.05)。结论对脑卒中后吞咽障碍患者给予DPNS为主的康复治疗,能有效改善吞咽功能,减少并发症的发生,促进疾病康复。
Objective To explore the effect of deep pharyngeal neuromuscular stimulation（DPNS） on rehabilitation of dysphagia after stroke. Methods A total of 70 cases with dysphagia after stroke from the department of rehabilitation in People＇s Hospital of Haian County from Jan. 2013 to Dec. 2015 were included as the research objects,according to the ran- dom number method they were divided into an observation group and a control group,35 cases each. The control group was given rehabilitation training on the basis of conventional stroke drug treatment; the observation group was given DPNS based rehabilitation including tightening reflex at bilateral soft palate smooth muscle, three side soft palate, tongue root, tongue side, tongue center and bilateral throat wall, and tongue root retraction reflex strength and small tongue/uvula stimulation on the basis of the control group＇s regimen,one week as a course,three courses in total After treatment, water swallow test score, standardized swallowing assessment （SSA）, video fluoroscopic swallowing study （VFSS） score, the rate of aspiration pneumonia, malnutrition rate of the two groups were observed. Results After treatment, the water swallow test score and SSA score of the observation group were lower than that before treatment,the VFSS score was higher than that before treatment; water swallow test score and SSA score of the observation group were lower than those of the control group[ （2.61 ± 0.23 ） score vs （3.54±0. 37） score, （24.90 ± 3.36） score vs （28.80± 3.42） score ], VFSS was higher than that of the control group [7.58 ±0. 64） score vs （6.04 ±0.59） score] （P 〈0.01 ）. After treatment,the rate of aspiration pneumonia and malnutrition in the observation group were lower than those of the control group [ 8.57% （3/35） vs 20.00% （7/35）, 11.43% （4/35） vs 25.71% （9/35） ] （ P 〈 0.05 ）. Conclusion The DPNS treatment of patients with dysphagia after stroke can effectively improve the swallowing function,reduce the complications and promote the rehabilitation.
出处
《医学综述》
2017年第24期4988-4992,共5页
Medical Recapitulate
