文章摘要

咽部冰刺激联合低频脉冲电刺激在脑卒中后吞咽障碍患者中的应用效果

作者: 1雷 铖, 1孙子 科技木, 1王 延芬, 1明 文文, 1李 黄艳
1 德阳市人民医院神经内科,四川 德阳 618000
通讯: 王 延芬 Email: 136359073@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.01.020
基金: 四川省卫生健康委员会科研课题(19PJ045);德阳市应用技术研究与开发资金项目(JYCX20160086)。

摘要

目的:观察咽部冰刺激联合低频脉冲电刺激在脑卒中后吞咽障碍患者康复治疗中的效果。方法:选择2017年4月至2018年4月在德阳市人民医院神经内科住院治疗的脑卒中后吞咽障碍的患者168例为研究对象,采用随机数字表法分为3组,每组各56例。对照组给予常规吞咽训练,电刺激组在对照组的基础上施加低频脉冲电刺激,联合刺激组在电刺激组基础上给予咽部冰刺激,干预时间为2周。对比分析3组患者治疗效果,包括洼田饮水试验、标准吞咽功能评分、吞咽障碍特异性生活质量评分和肺炎的发生率。结果:3组的治疗总有效率分别为76.4%(对照组)、96.4%(电刺激组)和98.1%(联合刺激组),差异有统计学意义(P<0.01);肺炎发生率分别为34.5%(对照组)、17.9%(电刺激组)和14.8%(联合刺激组),差异有统计学意义(P<0.01);干预后联合刺激组吞咽功能和生活质量评分均优于对照组,差异有统计学意义(P<0.01)。结论:咽部冰刺激联合低频脉冲电刺激能有效提高脑卒中后吞咽障碍患者的康复有效率,改善吞咽功能,并能够显著降低相关性肺炎发生率,从而提高患者的生活质量。
关键词: 脑卒中;吞咽障碍;电刺激;冰刺激

Effect of ice stimulation combined with electrical muscle stimulation in the treatment of dysphagia after stroke

Authors: 1LEI Cheng, 1SUNZI Kejimu, 1WANG Yanfen, 1MING Wenwen, 1LI Huangyan
1 Department of Neurology, People’s Hospital of Deyang City, Deyang Sichuan 618000, China

CorrespondingAuthor:WANG Yanfen Email: 136359073@qq.com

Foundation: This work was supported by the Scientific Research Project of Sichuan Provincial Health Committee (19PJ045) and Deyang Applied Technology Research and Development Fund Project (JYCX20160086), China.

Abstract

Objective: To observe the effect of pharyngeal ice stimulation combined with low-frequency pulse electrical stimulation in the rehabilitation of patients with dysphagia after stroke. Methods: A total of 168 cases of patients with dysphagia after acute stroke were selected as subjects. According to the order of admission, the subjects were divided into 3 groups (n=56 for each) by random number table. The control group was given conventional swallowing training, while the electrical stimulation group was given muscle electrical stimulation on the basis of the control group, the combined stimulation group was given ice stimulation on the basis of the electrical group. The intervention time was 2 weeks. The efficacy of treatment, Standardized Swallowing Assessment (SSA), Swallowing Quality-of-Life Questionnaire (SWAL-QOF), and incidence of pneumonia were compared between the 3 groups. Results: The total effective rates of the 3 groups were 76.4% (the control group), 96.4% (the electrical stimulation group) and 98.1% (the combined stimulation group), respectively., with statistically significant difference (P<0.01). The incidence of pneumonia was 34.5% (the control group), 17.9% (the electrical stimulation group) and 14.8% (the combined stimulation group), respectively (P<0.01). After the intervention, the scores of swallowing function and quality of life in the combined stimulation group were better than those in the control group, and the difference was statistically significant (P<0.01). Conclusion: Pharyngeal ice stimulation combined with low-frequency pulse electrical stimulation can effectively improve the rehabilitation efficiency, swallowing function, and significantly reduce the incidence of pneumonia, improve the quality of life of patients with dysphagia after stroke.
Keywords: stroke; dysphagia; electrical stimulation; ice stimulation