颈动脉内膜剥脱术致周围性舌下神经麻痹综合康复治疗:1例报道及文献复习

发布时间：2018-03-09 01:28

本文选题：舌下神经损伤　切入点：周围性舌下神经麻痹　出处：《神经病学与神经康复学杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的:周围性舌下神经麻痹的临床诊治率较低,相当一部分患者未能得到及时而正确的康复治疗。本文旨在报道颈动脉内膜剥脱术致周围性舌下神经麻痹的综合康复治疗方法及临床疗效。方法:2016年3月1日,天津医科大学总医院康复医学科收入1例颈动脉内膜剥脱术致周围性舌下神经麻痹患者,对该患者进行包括舌肌运动训练、神经肌肉电刺激疗法和远红外线治疗在内的为期15 d的综合康复治疗及口服神经营养药物治疗。回顾性分析诊治过程,并对相关文献进行复习。结果:接受综合康复治疗15 d后,舌肌较治疗前灵活,构音较治疗前清晰,吞咽时对食团的控制能力和搅拌能力均得到改善;伸舌虽然仍略向右偏斜,但舌正中沟与正中线的夹角较治疗前减少17.5°;右侧舌体表面皱褶减少,舌体饱满红润;舌尖向上可触及上嘴唇;向左舔嘴角时费力程度减轻;向右伸舌时颈部肌肉张力明显降低;向口腔内部卷曲舌尖可触及软腭边缘。康复治疗效果令人满意。结论:周围性舌下神经麻痹的康复治疗方法鲜见报道。在口服神经营养药物的基础上,同时应用舌肌运动训练、神经肌肉电刺激疗法和远红外线治疗在内的康复治疗方法,可以有效地改善患者的舌肌运动功能和舌肌萎缩程度,成为改善周围性舌下神经麻痹的安全而有效的康复治疗方法。
[Abstract]:Objective: the clinical diagnosis and treatment rate of peripheral hypoglossal paralysis is low. In order to report the comprehensive rehabilitation treatment and clinical effect of peripheral hypoglossal paralysis caused by carotid endarterectomy, a large number of patients failed to receive timely and correct rehabilitation treatment. Methods: March 1st 2016. A patient with peripheral hypoglossal nerve paralysis caused by carotid endarterectomy was enrolled in the Department of Rehabilitation Medicine, General Hospital of Tianjin Medical University. The patient was trained including tongue muscle exercise. A 15-day comprehensive rehabilitation therapy and oral neurotrophic drug therapy, including neuromuscular electrical stimulation and far infrared therapy. Results: after 15 days of comprehensive rehabilitation treatment, the tongue muscle was more flexible than before treatment, the structure sound was clearer than before treatment, the control ability and agitation ability of the food mass were improved during swallowing, and the tongue extension was still slightly oblique to the right. However, the angle between the median groove and the median line of the tongue was reduced by 17.5 掳compared with that before treatment; the surface folds of the right body of the tongue were reduced and the body of the tongue was plump and ruddy; the tip of the tongue could reach the upper lip upward; the degree of effort was reduced when licking the corner of the mouth to the left; the muscle tension of the neck decreased obviously when the tongue was extended to the right. Conclusion: there are few reports on the rehabilitation of peripheral hypoglossal paralysis. On the basis of oral neurotrophic drugs, tongue muscle exercise training is also used. The rehabilitation therapy including nerve muscle electrical stimulation and far infrared therapy can effectively improve the motor function of tongue muscle and the degree of tongue muscle atrophy. It is a safe and effective rehabilitation method to improve peripheral hypoglossal paralysis.
【作者单位】：天津医科大学总医院康复医学科;
【分类号】：R741

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