膈肌电刺激联合吞咽功能训练对脑卒中后吞咽功能障碍患者的治疗效果
Therapeutic effect of diaphragmatic electrical stimulation combined with swallowing function training on patients with post-stroke dysphagia
娄萍萍 1李永 1王笑丰 1孙小鹏 1黄琳琳1
作者信息
- 1. 大连市中心医院康复科,辽宁大连 116021
- 折叠
摘要
目的 观察膈肌电刺激联合吞咽功能训练对脑卒中后吞咽功能障碍患者的临床效果.方法 选取2023年1月至10月大连市中心医院康复科收治的60例脑卒中后吞咽障碍患者为研究对象,按照随机数字表法分为观察组(30例)和对照组(30例),对照组予以常规吞咽功能训练,观察组在对照组的基础上予以膈肌电刺激,持续治疗2周.比较两组的临床疗效、治疗前后标准吞咽功能评价量表(SSA)评分、吞咽障碍特异性生活质量表(SWAL-QOL)评分、洼田饮水试验评级及膈肌超声(膈肌厚度、膈肌运动幅度).结果 观察组患者治疗2周后整体临床疗效优于对照组,差异有统计学意义(P＜0.05);两组患者治疗2周后的SSA评分均低于治疗前,且观察组低于对照组,差异均有统计学意义(P＜0.05);两组患者治疗2周后SWAL-QOL评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P＜0.05);两组洼田饮水试验评级均优于治疗前,且观察组优于对照组,差异有统计学意义(P＜0.05);两组用力呼吸时膈肌活动度及膈肌增厚率均高于治疗前,且观察组高于对照组,差异均有统计学意义(P＜0.05).结论 膈肌电刺激联合吞咽功能训练治疗脑卒中后吞咽功能障碍疗效确切,可改善膈肌活动能力,提高吞咽功能.
Abstract
Objective To observe the clinical effectiveness of diaphragmatic electrical stimulation combined with swallow-ing function training in patients with post-stroke dysphagia.Methods A total of 60 patients with post-stroke dysphagia ad-mitted to the Rehabilitation Department of Dalian Central Hospital from January to October 2023 were selected as the re-search subjects.They were divided into an observation group(30 cases)and a control group(30 cases)according to random number table method.The control group received conventional swallowing function training,while the observation group re-ceived diaphragmatic electrical stimulation on top of the conventional training for two weeks.The clinical efficacy,standard swallowing assessment scale(SSA),swallowing disorder-specific quality of life(SWAL-QOL)score,water swallowing test grades,and diaphragmatic ultrasound parameters(diaphragmatic thickness and range of motion)were compared between the two groups.Results The overall clinical efficacy of the observation group was better than that of the control group after 2 weeks of treatment,with a statistically significant difference(P＜0.05).There was no significant difference in the total effec-tive rate between the two groups(P＞0.05).The SSA scores of both groups were lower after 2 weeks of treatment than before treatment,and the scores of the observation group were lower than those of the control group,with significant differences(P＜0.05).The SWAL-QOL scores of both groups were higher after 2 weeks of treatment than before treatment,and the scores of the observation group were higher than those of the control group,with significant differences(P＜0.05).The rat-ings of the water swallowing test were better after treatment than before treatment in both groups,and the ratings of the ob-servation group were better than those of the control group,with significant differences(P＜0.05).The diaphragmatic activity and thickening rate during forced breathing were higher after treatment than before treatment in both groups,and the values of the observation group were higher than those of the control group,with significant differences(P＜0.05).Conclusion Di-aphragmatic electrical stimulation combined with swallowing function training is effective in treating post-stroke dysphagia,improving diaphragmatic activity,and enhancing swallow-ing function.
关键词
脑卒中/吞咽障碍/膈肌电刺激/吞咽功能训练Key words
Stroke/Dysphagia/Diaphragmatic electrical stimulation/Swallowing function training引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据