颌下肌群重复周围磁刺激对卒中后吞咽障碍患者吞咽功能的影响

发布时间：2018-03-12 21:26

本文选题：重复周围磁刺激　切入点：吞咽障碍　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨颌下肌群重复周围磁刺激对于亚急性期脑卒中后吞咽障碍患者吞咽功能的影响。方法:选取40例亚急性期脑卒中后吞咽障碍患者,按照入院时间编号,随机分配到治疗组和对照组,治疗组给予常规吞咽训练和颌下肌群重复周围磁刺激治疗,对照组仅给予常规吞咽训练,两组患者每天治疗1次,每次30分钟,每周5天,共2周。治疗前后分别行藤岛一郎吞咽障碍评分、才藤氏七级评价和表面肌电图检查,2周后观察对比两组患者吞咽功能变化:藤岛一郎吞咽障碍评分、才藤氏七级评价、和颌下肌群表面肌电图吞咽时程及最大振幅的改变。结果:两组患者治疗2周后吞咽功能较前均有改善,组内比较:两组患者治疗后较治疗前藤岛一郎吞咽障碍评分、才藤氏七级评价法评分改善,差异具有统计学意义(P0.05),表面肌电图示最大振幅增高,吞咽时限缩短,差异具有统计学意义(P0.05);组间比较:治疗组患者藤岛一郎吞咽障碍评分高于对照组,差异具有统计学意义(P=0.038),才藤氏七级评价法,治疗后治疗组改善较对照组改善,差异具有统计学意义(P=0.006),治疗组表面肌电图吞咽时程较对照组缩短,差异具有统计学意义(P=0.005),治疗组表面肌电图吞咽最大振幅增高相对于对照组未表现出明显差异(P=0.352)。结论:重复周围磁刺激联合常规吞咽训练较单纯常规吞咽训练可以更好地改善患者吞咽功能,缩短吞咽时程,主要表现为提高卒中后吞咽障碍患者吞咽肌群的灵活性、协调性,因此临床上可选择性采用重复周围磁刺激治疗卒中后吞咽障碍。
[Abstract]:Objective: to investigate the effect of repeated peripheral magnetic stimulation of submandibular muscles on swallowing function in patients with dysphagia after subacute stroke. They were randomly assigned to the treatment group and the control group. The treatment group received routine swallowing training and repeated peripheral magnetic stimulation of the submaxillary muscle group, while the control group only received routine swallowing training. The patients in the two groups were treated once a day for 30 minutes, 5 days a week. Before and after treatment, the patients' swallowing function was evaluated and compared with that of Fujiichiro's grade 7 evaluation and surface electromyography (EMG) two weeks after treatment: Ichiro Fujiichiro's dysphagia score and Teng's grade 7 evaluation were compared and observed after 2 weeks of treatment, 2 weeks after treatment, the changes of swallowing function were compared between the two groups. Results: after two weeks of treatment, the swallowing function was improved in both groups, and the scores of dysphagia in the two groups were compared with those before treatment. The score of Caiteng's grade 7 evaluation method was improved, the difference was statistically significant (P 0.05), the maximum amplitude of surface electromyogram was increased, and the time of swallowing was shortened. Comparison between groups: the score of dysphagia in the treatment group was higher than that in the control group, and the difference was statistically significant (P < 0.05). The improvement of the treatment group was better than that of the control group after treatment. The difference was statistically significant (P < 0. 006). The duration of swallowing by EMG in the treatment group was shorter than that in the control group. The difference was statistically significant. The maximum amplitude of surface electromyogram swallowing in the treatment group was higher than that in the control group. Conclusion: repeated peripheral magnetic stimulation combined with routine swallowing training is more effective than routine swallowing training. Better improve patients' swallowing function, The main manifestation of shortening the duration of swallowing is to improve the flexibility and coordination of swallowing muscle group in patients with dysphagia after stroke, so repeated magnetic stimulation can be used to treat dysphagia after stroke.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3;R493

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