不同频率重复经颅磁刺激对脑卒中吞咽功能障碍患者吞咽功能及其表面肌电图的影响

发布时间：2018-05-31 05:01

本文选题：重复经颅磁刺激 + 脑卒中　；参考：《重庆医学》2017年32期

【摘要】：目的探究不同频率重复经颅磁刺激(rTMS)对脑卒中吞咽功能障碍患者吞咽功能及其表面肌电图(sEMG)的影响。方法选取2013年1月至2016年1月该院收治的56例脑卒中吞咽功能障碍患者为研究对象,将患者采用随机数表法分为观察组和对照组,各28例。两组患者均进行常规神经内科药物治疗和吞咽训练,观察组患者在此基础上进行经颅磁刺激,其中14例患者采用低频经颅磁刺激为低频组,14例患者采用高频经颅磁刺激为高频组。对比3组患者治疗前和治疗后洼田饮水试验情况、吞咽功能评分和sEMG检测情况。结果治疗后低频组、高频组和对照组的吞咽功能评分分别为(7.65±0.88)、(7.29±0.82)和(6.10±0.85)分,舌骨上下肌群sEMG最大波幅值分别为(741.90±46.06)、(695.38±43.28)、(565.00±41.29)μV,低频组和高频组均优于对照组,且低频组优于高频组,差异有统计学意义(P0.05)。结论脑卒中吞咽功能障碍患者经低频rTMS治疗能够更好的提高吞咽功能,且通过监测舌骨上下肌群表面肌电图变化能够较好地评估患者吞咽功能障碍改善情况。
[Abstract]:Objective to investigate the effects of repeated transcranial magnetic stimulation (TMS) at different frequencies on swallowing function and surface electromyography (EMG) in stroke patients with dysphagia. Methods 56 stroke patients with dysphagia were selected from January 2013 to January 2016. The patients were randomly divided into two groups: observation group (n = 28) and control group (n = 28). The patients in both groups were treated with routine neuromedical drugs and swallowing training, and the patients in the observation group were treated with transcranial magnetic stimulation. Fourteen patients were treated with low frequency transcranial magnetic stimulation. 14 patients with high frequency transcranial magnetic stimulation were treated with high frequency transcranial magnetic stimulation. The drinking water test, swallowing function score and sEMG test were compared before and after treatment. Results after treatment, the scores of swallowing function in low frequency group, high frequency group and control group were 7.65 卤0.88, 7.29 卤0.82) and 6.10 卤0.85), respectively. The maximum amplitude of sEMG in inferior hyoid muscle group was 695.38 卤43.28565.00 卤41.29 渭 V, respectively. The low frequency group and high frequency group were superior to the control group, and the low frequency group was superior to the high frequency group. The difference was statistically significant (P 0.05). Conclusion low frequency rTMS can improve the swallowing function of stroke patients with dysphagia, and the improvement of swallowing dysfunction can be evaluated by monitoring the changes of surface electromyography of superior and inferior hyoid muscles.
【作者单位】：广东医科大学附属医院神经内科;
【基金】：广东省湛江市科技计划项目(2016B01166)
【分类号】：R743.3

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