| 摘要: |
| 目的 探讨神经肌肉电刺激联合吞咽法对急性缺血性脑卒中后吞咽障碍患者的治疗效果。方法 回顾性连续纳入2013年9月至2016年9月在我院脑血管病中心住院治疗的急性缺血性脑卒中后吞咽障碍患者104例。根据治疗方法分为对照组（31例）和治疗组（73例），对照组给予常规脑血管病内科治疗，治疗组在常规脑血管病内科治疗基础上给予神经肌肉电刺激联合吞咽法治疗。比较两组治疗前后洼田饮水试验（WST）评分变化、肺部感染发生率、胃管拔除率等。结果 两组患者年龄、性别、基线WST评分和住院天数等基线资料差异均无统计学意义（P均>0.05）。治疗后治疗组患者的WST评分小于对照组[（1.39±0.85）分vs（2.71±1.16）分，F=17.236，P<0.001]，WST评分降低值大于对照组[（2.60±0.89）分vs（1.29±0.46）分，F=19.910，P<0.001]，肺部感染发生率低于对照组[20.55%（15/73）vs 64.52%（20/31），χ2=18.840，P<0.001]，胃管拔除变化率高于对照组[52.05%（38/73）vs 25.81%（8/31），χ2=6.078，P=0.014]。结论 神经肌肉电刺激联合吞咽法治疗脑卒中后吞咽障碍，可有效改善急性缺血性脑卒中吞咽障碍患者的吞咽功能，降低肺部感染发生率。 |
| 关键词: 神经肌肉电刺激 吞咽障碍 吞咽法 急性缺血性脑卒中 |
| DOI：10.16781/j.0258-879x.2018.09.1052 |
| 投稿时间：2018-07-27修订日期：2018-08-18 |
| 基金项目:上海市科技创新行动计划重点项目（14401970304）. |
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| Effectiveness of neuromuscular electrical stimulation combined with swallowing training for dysphagia after acute ischemic stroke |
| YUAN Hui,YU Long-juan,XIE Shan,ZHA Yi,DENG Ben-qiang,WU Tao* |
(Stroke Center, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To explore the effect of neuromuscular electrical stimulation combined with swallowing training for dysphagia after acute ischemic stroke. Methods A total of 104 patients with dysphagia after acute ischemic stroke receiving treatment in Stroke Center of Changhai Hospital of Navy Medical University (Second Military Medical University) between Sep. 2013 and Sep. 2016 were retrospectively enrolled. According to the treatment method, the patients were divided into treatment group and control group. The 73 patients in the treatment group received neuromuscular electrical stimulation combined with swallowing training, and the 31 patients in the control group received conventional treatment. The change of water swallow test (WST) score, pulmonary infection incidence and gastric tube removal rate were compared between the two groups. Results There were no significant differences in gender, age, baseline WST score or hospital stay between the two groups (all P>0.05). The WST score after intervention was significantly lower in the treatment group than that in the control group ([1.39±0.85] vs[2.71±1.16], F=17.236, P<0.001). The decreased WST score was significantly higher in the treatment group than that in the control group ([2.60±0.89] vs[1.29±0.46], F=19.910, P<0.001). The incidence of pulmonary infection was significantly lower in the treatment group than that in the control group (20.55%[15/73] vs 64.52%[20/31], χ2=18.840, P<0.001). The removal rate of gastric tube was significantly higher in the treatment group than that in the control group (52.05%[38/73] vs 25.81%[8/31], χ2=6.078, P=0.014). Conclusion Neuromuscular electrical stimulation combined with swallowing training can improve swallowing function and reduce the incidence of pulmonary infection in the patients with dysphagia after acute ischemic stroke. |
| Key words: neuromuscular electrical stimulation deglutition disorders swallowing training acute ischemic stroke |
