中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2012年
11期
818-820
,共3页
神经肌肉电刺激%吞咽障碍%脑损伤
神經肌肉電刺激%吞嚥障礙%腦損傷
신경기육전자격%탄인장애%뇌손상
Neuromuscular electrical stimulation%Dysphagia%Brain lesions,Swallowing
目的 观察神经肌肉电刺激治疗脑损伤后吞咽障碍的疗效.方法 按随机数字表法将急性脑损伤后发生吞咽障碍的患者64例分为A组(n=21)、B组(n=22)和C组(n =21例).3组患者均采用神经内科常规药物治疗和常规护理,在此基础上均采用不同参数的神经肌肉电刺激.治疗参数:A组波宽(T)为700 ms,脉冲间歇(R)为2 s,频率为0.19 Hz；B组患者T为700 ms,R为l s,频率为0.29 Hz;C组患者T为340 ms,R为400 ms,频率为0.68 Hz.3组患者均于治疗前和治疗4周后(治疗后)采取洼田饮水试验对其吞咽障碍的症状进行分级评定.结果 治疗前,3组患者的洼田饮水试验评分差异无统计学意义(P＞0.05).治疗后,A组、B组和C组与各自治疗前相比,评分均有降低,差异均有统计学意义(P＜0.01)；A组的疗效显著优于B组和C组,而B组的疗效也优于C组,差异均有统计学意义(P＜0.05).A组总有效率为80.95％优于B的72.73％和C组的66.67％,且B组总有效率亦优于C组,差异均有统计学意义(P＜0.05).结论 神经肌肉电刺激疗效肯定,其中以T为700 ms,R为2 s,频率为0.19 Hz的低频刺激的疗效最为显著.
目的 觀察神經肌肉電刺激治療腦損傷後吞嚥障礙的療效.方法 按隨機數字錶法將急性腦損傷後髮生吞嚥障礙的患者64例分為A組(n=21)、B組(n=22)和C組(n =21例).3組患者均採用神經內科常規藥物治療和常規護理,在此基礎上均採用不同參數的神經肌肉電刺激.治療參數:A組波寬(T)為700 ms,脈遲間歇(R)為2 s,頻率為0.19 Hz；B組患者T為700 ms,R為l s,頻率為0.29 Hz;C組患者T為340 ms,R為400 ms,頻率為0.68 Hz.3組患者均于治療前和治療4週後(治療後)採取窪田飲水試驗對其吞嚥障礙的癥狀進行分級評定.結果 治療前,3組患者的窪田飲水試驗評分差異無統計學意義(P＞0.05).治療後,A組、B組和C組與各自治療前相比,評分均有降低,差異均有統計學意義(P＜0.01)；A組的療效顯著優于B組和C組,而B組的療效也優于C組,差異均有統計學意義(P＜0.05).A組總有效率為80.95％優于B的72.73％和C組的66.67％,且B組總有效率亦優于C組,差異均有統計學意義(P＜0.05).結論 神經肌肉電刺激療效肯定,其中以T為700 ms,R為2 s,頻率為0.19 Hz的低頻刺激的療效最為顯著.
목적 관찰신경기육전자격치료뇌손상후탄인장애적료효.방법 안수궤수자표법장급성뇌손상후발생탄인장애적환자64례분위A조(n=21)、B조(n=22)화C조(n =21례).3조환자균채용신경내과상규약물치료화상규호리,재차기출상균채용불동삼수적신경기육전자격.치료삼수:A조파관(T)위700 ms,맥충간헐(R)위2 s,빈솔위0.19 Hz；B조환자T위700 ms,R위l s,빈솔위0.29 Hz;C조환자T위340 ms,R위400 ms,빈솔위0.68 Hz.3조환자균우치료전화치료4주후(치료후)채취와전음수시험대기탄인장애적증상진행분급평정.결과 치료전,3조환자적와전음수시험평분차이무통계학의의(P＞0.05).치료후,A조、B조화C조여각자치료전상비,평분균유강저,차이균유통계학의의(P＜0.01)；A조적료효현저우우B조화C조,이B조적료효야우우C조,차이균유통계학의의(P＜0.05).A조총유효솔위80.95％우우B적72.73％화C조적66.67％,차B조총유효솔역우우C조,차이균유통계학의의(P＜0.05).결론 신경기육전자격료효긍정,기중이T위700 ms,R위2 s,빈솔위0.19 Hz적저빈자격적료효최위현저.
Objective To evaluate the effect of neuromuscular electrical stimulation (NMES) on swallowing function in brain injury patients with dysphagia.Methods Sixty-four patients with dysphagia were divided into A group (n=21,stimulated with T =700 ms,R =2 s,frequency =0.19 Hz),B group (n =22,T =700 ms,R =1 s,frequency =0.29 Hz),and C group (n =21,T =340 ms,R =400 ms,frequency =0.68 Hz).One pair of electrodes was placed at the midline under the chin over the submental muscle group.The intensity of stimulation ranged from 5 to 11 mA.The treatments were once a day,5 times a week,with 20 times as one course.The results were assessed with Kubota's water swallowing test before and 4 weeks after treatment.Results The water swallowing test scores were significantly reduced after treatment in all 3 groups,with significantly greater reductions in A group compared with B and C group.The effectiveness rate was 81％ in A group,73％ in B group and 67％ in C group,all statistically significant differences.Conclusion NMES can be an effective and safe treatment for dysphagia after brain injury.NMES appears to be most effective with T =700 ms,R =2 s,and a frequency of 0.19 Hz.
