摘要
目的探讨肌电生物反馈干预联合直接摄食训练对脑卒中后吞咽障碍患者吞咽功能及吞咽相关肌肉系统功能状态的影响。方法回顾性分析2019年3月至2021年3月开滦总医院收治的100例急性缺血性脑卒中患者的临床干预资料,根据患者接受干预方式的不同分为观察组和对照组,每组50例。对照组接受直接摄食训练,观察组在对照组基础上接受肌电生物反馈干预疗法,两组均持续干预2个月。评估并比较两组干预效果;干预前后,采用表面肌电图信号分析技术评估两组舌骨上肌群肌电积分值,比较两组患者干预前后的简化Fugl-Meyer运动功能积分(FMA)以及血清前白蛋白(PA)、白蛋白(ALB)、氮平衡(NB)、体重指数(BMI)指标水平。结果观察组干预总有效率为96.00%,高于对照组的84.00%,差异有统计学意义(P<0.05)。干预后,观察组舌骨上肌群肌电积分值为(29.53±5.73)分,高于对照组[(21.75±6.27)分],差异有统计学意义(P<0.05)。干预后,观察组患者PA、ALB、NB、BMI指标水平为(260.48±20.83)mg/L、(42.54±5.52)g/L、(1.61±0.52)g/d、(23.22±2.12)kg/m^(2),均高于对照组[(223.47±21.48)mg/L、(35.23±5.47)g/L、(1.23±0.57)g/d、(20.34±1.98)kg/m^(2)],差异均有统计学意义(P<0.05)。干预后,观察组FMA评分为(78.53±9.48)分,高于对照组[(51.35±10.45)分],差异有统计学意义(P<0.05)。结论脑卒中吞咽障碍患者在直接摄食训练基础上辅以肌电生物反馈干预可以明显改善患者的吞咽功能及营养状况,提高干预效果和肢体运动功能。
Objective To investigate the effect of electromyographic biofeedback intervention combined with direct feeding training on swallowing function and the functional state of swallowing-related muscular system in patients with dysphagia after stroke.Methods The clinical intervention data of 100 patients with acute ischemic stroke admitted to Kailuan General Hospital from March 2019 to March 2021 were retrospectively analyzed.They were divided into a study group and a control group according to the intervention methods the patients received,with 50 cases in each group.The control group received direct feeding training,and the observation group received EMG biofeedback intervention on the basis of the control group,both groups were continuously intervened for 2 months.The intervention effects of the two groups were evaluated and compared.Before and after the intervention,the surface EMG signal analysis technology was used to evaluate the EMG scores of the suprahyoid muscles of the two groups;the levels of simplified Fugl-Meyer motor function score(FMA),and serum prealbumin(PA),albumin(ALB),nitrogen Balance(NB)and body mass index(BMI)of the two groups were compared before and after the intervention.Results The total effective intervention of the observation group was 96.00%,which was higher than the 84.00%of the control group,and the difference was statistically significant(P<0.05).After the intervention,the EMG scores of the suprahyoid muscle group in the observation group were(29.53±5.73)points,which were higher than those in the control group[(21.75±6.27)points],the differences were statistically significant(P<0.05).After the intervention,the levels of PA,ALB,NB,BMI in the observation group were(260.48±20.83)mg/L,(42.54±5.52)g/L,(1.61±0.52)g/d,(23.22±2.12)kg/m^(2),which were higher than those in the control group[(223.47±21.48)mg/L,(35.23±5.47)g/L,(1.23±0.57)g/d,(20.34±1.98)kg/m^(2)],the differences were statistical significant(P<0.05).After the intervention,the FMA scores in the observation group were(78.53±9.48)points,which were higher than those in the control group[(51.35±10.45)points],the differences were statistically significant(P<0.05).Conclusion In stroke patients with dysphagia,supplemented with electromyographic biofeedback intervention on the basis of direct feeding training can significantly improve the swallowing function and nutritional status of the patients,and improve the intervention effect and limb motor function.
作者
杨秀平
赵尧辉
冯玉婧
李雪梅
杨娜
YANG Xiu-ping;ZHAO Yao-hui;FENG Yu-jing(Department of Neurology,Kailuan General Hospital,Tangshan Hebei 063000,China;Luoyang First People's Hospital,Luoyang Henan 471000,China)
出处
《临床和实验医学杂志》
2021年第23期2508-2512,共5页
Journal of Clinical and Experimental Medicine
基金
河北省2018年医学科学研究重点课题计划(编号:20181448)。
关键词
脑卒中
吞咽障碍
肌电生物反馈
直接摄食训练
吞咽功能
吞咽相关肌肉系统功能状态
Stroke
Dysphagia
Electromyographic biofeedback
Direct feeding training
Swallowing function
Functional status of swallowing-related muscle system
