CAJ | 학술논문

目的：探讨神经肌肉电刺激联合吞咽训练治疗脑卒中后吞咽障碍的临床效果。方法选择2009年1月～2013年10月来本院治疗的脑卒中后吞咽功能障碍患者165例，按照入院顺序分为观察组83例，采用神经肌肉电刺激联合吞咽训练治疗，对照组82例，单独采用吞咽训练治疗。比较两组sEMG最大波幅、SSA评分、VFSS评分及SWAL-QOL评分并分析其相关性。结果对照组及观察组治疗后sEMG最大波幅、VFSS评分均高于治疗前，SSA评分、SWAL-QOL评分均低于治疗前，差异有统计学意义（P＜0.05），且观察组较对照组改善幅度更大，差异有统计学意义（P＜0.05）。 sEMG负相关于SSA、SWAL-QOL，正相关于VFSS（P＜0.05），SSA负相关于VFSS，正相关于SWAL-QOL（P＜0.05），VFSS负相关于SWAL-QOL（P＜0.05）。结论神经肌肉电刺激联合吞咽训练治疗脑卒中后吞咽障碍能促进患者吞咽功能的恢复，可以在临床推广应用。
목적：탐토신경기육전자격연합탄인훈련치료뇌졸중후탄인장애적림상효과。방법선택2009년1월～2013년10월래본원치료적뇌졸중후탄인공능장애환자165례，안조입원순서분위관찰조83례，채용신경기육전자격연합탄인훈련치료，대조조82례，단독채용탄인훈련치료。비교량조sEMG최대파폭、SSA평분、VFSS평분급SWAL-QOL평분병분석기상관성。결과대조조급관찰조치료후sEMG최대파폭、VFSS평분균고우치료전，SSA평분、SWAL-QOL평분균저우치료전，차이유통계학의의（P＜0.05），차관찰조교대조조개선폭도경대，차이유통계학의의（P＜0.05）。 sEMG부상관우SSA、SWAL-QOL，정상관우VFSS（P＜0.05），SSA부상관우VFSS，정상관우SWAL-QOL（P＜0.05），VFSS부상관우SWAL-QOL（P＜0.05）。결론신경기육전자격연합탄인훈련치료뇌졸중후탄인장애능촉진환자탄인공능적회복，가이재림상추엄응용。
Objective To investigate the clinical effect of the swallowing training joint neuromuscular electrical stimula-tion to treat dysphagia after stroke. Methods A total of 165 patients with swallowing dysfunction stroke were selected from Jan 2009 to Oct 2013 in our hospital, they were divided into two groups according to the order of admission, there were 83 cases in the observation group, which used neuromuscular electrical stimulation therapy combined with swal-lowing training, there were 82 cases in the control group treated by alone swallowing training therapy. The largest sEMG amplitude, SSA score, VFSS score and SWAL-QOL score of two groups were compared and its relevance was analyzed. Results The sEMG maximum amplitude, VFSS scores of The control group and the observation group after treatment were higher than before treatment, SSA score, SWAL-QOL scores were lower than before treatment, the dif-ference was significant (P<0.05), and the observation group after treatment with greater magnitude improvement than con-trol group, the difference was significant (P<0.05). sEMG negative correlation with SSA, SWAL-QOL, and positive cor-relation with VFSS (P <0.05), SSA negative correlation with VFSS, and positive correlation with SWAL-QOL (P<0.05), VFSS negative correlation with SWAL-QOL(P <0.05). Conclusion Neuromuscular electrical stimulation combined con-clusion after swallowing training in the treatment of stroke patients with dysphagia can promote the recovery of swallow-ing function and can be popularized in clinical application.