强化NMES对脑卒中吞咽障碍患者吞咽功能及舌骨喉运动速度的影响

发布时间：2018-05-24 22:19

本文选题：神经肌肉电刺激 + 舌骨喉复合体运动速度　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:观察不同时间的神经肌肉电刺激(NMES)对脑卒中后吞咽障碍患者的临床疗效及舌骨喉复合体运动速度的影响。方法:将30例符合入选标准的脑卒中咽期吞咽功能障碍患者按随机数字表分为对照组、NMES组和强化NMES组,每组各10例。3组患者均给予常规吞咽功能训练,在此基础上NMES组给予每日1次神经肌肉电刺激,强化NMES组给予每日2次神经肌肉电刺激,共治疗4周。分别于治疗前、治疗2周及4周后进行视频透视吞咽检查(VFSS),测量舌骨、甲状软骨在吞咽半流质食物时向前、向上的运动幅度、时间,计算运动速度,同时采用洼田饮水试验、才藤分级、Rosenbek渗透-误吸量表(PAS)对3组患者进行疗效评定。结果:治疗后,3组患者洼田饮水试验、才藤分级、PAS评分均较治疗前明显改善(P0.05);洼田饮水试验在治疗2周后,强化NMES组、NMES组显效率高于对照组(P0.05);才藤分级在治疗2周、4周后强化NMES组有效率高于对照组;PAS评分在强化NMES组治疗2周[(3.30±0.82)分]、4周[(2.10±0.88)分]后较NMES组、对照组均明显改善,差异具有统计学意义(P0.05)。舌骨前移速度中强化NMES组在治疗2周[(20.52±8.39)mm/s]、4周[(33.00±19.83)mm/s]后较NMES组及对照组增快;同时PAS评分与舌骨前移速度Pearson相关性分析呈中度相关(P0.05)。结论:强化NMES对于改善吞咽障碍患者吞咽功能优于NMES,舌骨喉复合体运动速度增快可明显改善吞咽障碍的治疗效果。
[Abstract]:Aim: to observe the effects of neuromuscular electrical stimulation (NMES) on dysphagia and hyoid laryngeal complex motion in patients with dysphagia after stroke. Methods: thirty patients with stroke dysphagia were randomly divided into control group (n = 10) and NMES group (n = 10). On this basis, the NMES group was treated with neuromuscular electrical stimulation once a day, while the NMES group was treated with neuromuscular electrical stimulation twice a day for 4 weeks. Before treatment, 2 weeks and 4 weeks after treatment, video fluoroscopy was performed to examine the hyoid bone and thyroid cartilage. The amplitude, time and velocity of movement were measured before and 2 weeks and 4 weeks after the treatment, respectively. At the same time, the depression-drinking water test was used to measure the movement amplitude, time and velocity of the hyoid bone and thyroid cartilage in the course of swallowing half fluid food. Rosenbek osmotic and false aspiration scale was used to evaluate the curative effect of three groups of patients. Results: after treatment, the scores of sag water test and pas scores were significantly improved in the three groups than before, and after 2 weeks of treatment, the scores of pas were significantly improved in the three groups of patients, and after 2 weeks of treatment, the scores of pas were significantly improved in the three groups. The markedly effective rate of NMES group was higher than that of control group (P 0.05), the effective rate of enhanced NMES group was higher than that of control group after 2 weeks and 4 weeks of treatment, and the score of pas was significantly higher than that of NMES group after 2 weeks [3.30 卤0.82] weeks of intensive NMES treatment [2.10 卤0.88]. The difference was statistically significant (P 0.05). After 2 weeks of treatment [20.52 卤8.39)mm/s] and 4 weeks [33.00 卤19.83)mm/s], the hyoid anterior displacement velocity in the NMES group increased faster than that in the NMES group and the control group, and the correlation analysis between PAS score and hyoid anterior displacement velocity (Pearson) showed a moderate correlation (P 0.05). Conclusion: enhanced NMES can improve the swallowing function of patients with dysphagia, and the faster motion of hyoid laryngeal complex can obviously improve the therapeutic effect of dysphagia.
【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

【参考文献】