摘要
目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年1月至2023年9月收治的84例CS后DAS患者进行回顾性研究,按治疗方案不同分为参照组(n=42)、研究组(n=42)。其中采用吞咽低频电刺激治疗的患者设为参照组,采用CTAR联合吞咽低频电刺激治疗的患者设为研究组。比较两组治疗前、治疗4周后吞咽功能障碍分级情况、标准吞咽功能评定量表(SSA)评分、功能性经口舌摄食量表(FOIS)评分、舌骨喉活动度、表面肌电图、吞咽障碍特异性生命质量量表(SWAL-QOL)评分。结果研究组治疗4周后吞咽功能障碍改善情况优于参照组(P<0.05);研究组治疗4周后SSA评分为(24.18±2.12)分,低于参照组(28.79±3.77)分,FOIS评分为(5.68±0.45)分,高于参照组(4.63±0.51)分(P<0.05);研究组治疗4周后舌骨前移、上移活动度分别为(11.47±2.55)mm、(17.38±4.59)mm,高于参照组(8.25±1.06)mm、(14.03±4.56)mm(P<0.05);研究组治疗4周后最大波幅为(725.38±55.02)V,高于参照组(605.98±49.65)V,吞咽时程为(1.11±0.15)s,短于参照组(1.33±0.21)s(P<0.05);研究组治疗4周后SWAL-QOL评分为(125.32±15.32)分,高于参照组(102.54±14.25)分(P<0.05)。结论CTAR联合吞咽低频电刺激治疗CS后DAS患者可有效提高舌骨喉活动度,改善吞咽、摄食功能,促进生活质量提升。
Objective To explore the efficacy of chin tuck against resistance(CTAR)combined with low-frequency electrical stimulation of swallowing in the treatment of dysphagia after action stroke(DAS)patients after cerebral stroke(CS).Methods A retrospective study was conducted on 84 patients with post-CS DAS admitted to the Rehabilitation Department of Yucheng County People's Hospital from January 2021 to September 2023 by paired case-control study method,and they were divided into reference group(n=42)and study group(n=42)according to different treatment regimens.The patients receiving low-frequency electrical stimulation of swallowing were set as the reference group,and those receiving CTAR combined with low-frequency electrical stimulation of swallowing were set as the study group.The classification of swallowing dysfunction,standardized swallowing assessment(SSA)scores,functional oral intake scale(FOIS)scores,hyolaryngeal activity,surface electromyography and swallowing quality of life(SWAL-QOL)scores were compared between the two groups before treatment and 4 weeks after treatment.Results After 4 weeks of treatment,the improvement of swallowing dysfunction in the study group was better than that in the control group(P<0.05).After 4 weeks of treatment,the SSA score of the study group was(24.18±2.12)points,lower than that of the reference group(28.79±3.77)points,the FOIS score was(5.68±0.45)points,higher than that of the reference group(4.63±0.51)points(P<0.05).After 4 weeks of treatment,the anterior and upward motion of hyoid in the study group were(11.47±2.55)mm and(17.38±4.59)mm,respectively,which were higher than those in the control group(8.25±1.06)mm and(14.03±4.56)mm(P<0.05).After 4 weeks of treatment,the maximum amplitude of the study group was(725.38±55.02)V,higher than that of the reference group(605.98±49.65)V,and the swallowing time was(1.11±0.15)s,shorter than that of the reference group(1.33±0.21)s(P<0.05).The SWAL-QOL score of the study group was(125.32±15.32)points after 4 weeks of treatment,which was higher than that of the control group(102.54±14.25)points(P<0.05).Conclusion CTAR combined with lowfrequency electrical stimulation of swallowing can effectively improve the hyoid laryngeal motion,improve the swallowing and oral intake function,and promote the quality of life of DAS patients after CS.
作者
刘蕊
王景涛
谭志梅
LIU Rui;WANG Jing-tao;TAN Zhi-mei
出处
《中国疗养医学》
2024年第5期86-90,共5页
Chinese Journal of Convalescent Medicine
关键词
下颏抗阻力训练
吞咽低频电刺激
脑卒中
吞咽障碍
舌骨喉活动度
摄食功能
生活质量
Chin tuck against resistance
Low-frequency electrical stimulation of swallowing
Cerebral stroke
Dysphagia
Hyolaryngeal motion
Oral intake function
Quality of life
