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
2014年
4期
274-277
,共4页
徐明馨%王强%孟萍萍%姜丽
徐明馨%王彊%孟萍萍%薑麗
서명형%왕강%맹평평%강려
神经肌肉电刺激%吞咽障碍%吞咽训练%洼田饮水试验%视频透视吞咽检查
神經肌肉電刺激%吞嚥障礙%吞嚥訓練%窪田飲水試驗%視頻透視吞嚥檢查
신경기육전자격%탄인장애%탄인훈련%와전음수시험%시빈투시탄인검사
Neuromuscular electrical stimulation%Dysphagia%Swallowing training%Kubota water drinking test%Videofluoroscopy
目的 观察不同强度的神经肌肉电刺激(NMES)对卒中后吞咽功能障碍患者的影响.方法 将30例咽期吞咽功能障碍患者按随机数字表法分为对照组、NMES组和强化NMES组,每组10例.3组患者均给予常规吞咽功能训练,NMES组和强化NMES组在此基础上辅以神经肌肉低频电刺激,NMES组每日1次,强化NMES组每日2次.治疗前、治疗2周及4周后采用洼田饮水试验和视频透视吞咽检查(VFSS)对疗效进行评定.结果 治疗2周后,强化NMES组治疗显效率明显高于对照组,差异有统计学意义(P＜0.05);治疗2周后,各组患者VFSS评分均较治疗前增高(P＜0.05);与对照组治疗2周后比较,NMES组[(8.100±1.287)分]和强化NMES组[(9.000±0.943)分]VFSS评分均高于对照组[(7.200±1.814)分](P＜0.05),且强化NMES组VFSS评分高于NMES组(P＜0.05).结论 NMES可明显提高脑卒中患者的吞咽反射水平及咽部肌肉的收缩功能,增强吞咽再学习的训练疗效,在吞咽功能训练基础上,强化NMES的疗效优于NMES.
目的 觀察不同彊度的神經肌肉電刺激(NMES)對卒中後吞嚥功能障礙患者的影響.方法 將30例嚥期吞嚥功能障礙患者按隨機數字錶法分為對照組、NMES組和彊化NMES組,每組10例.3組患者均給予常規吞嚥功能訓練,NMES組和彊化NMES組在此基礎上輔以神經肌肉低頻電刺激,NMES組每日1次,彊化NMES組每日2次.治療前、治療2週及4週後採用窪田飲水試驗和視頻透視吞嚥檢查(VFSS)對療效進行評定.結果 治療2週後,彊化NMES組治療顯效率明顯高于對照組,差異有統計學意義(P＜0.05);治療2週後,各組患者VFSS評分均較治療前增高(P＜0.05);與對照組治療2週後比較,NMES組[(8.100±1.287)分]和彊化NMES組[(9.000±0.943)分]VFSS評分均高于對照組[(7.200±1.814)分](P＜0.05),且彊化NMES組VFSS評分高于NMES組(P＜0.05).結論 NMES可明顯提高腦卒中患者的吞嚥反射水平及嚥部肌肉的收縮功能,增彊吞嚥再學習的訓練療效,在吞嚥功能訓練基礎上,彊化NMES的療效優于NMES.
목적 관찰불동강도적신경기육전자격(NMES)대졸중후탄인공능장애환자적영향.방법 장30례인기탄인공능장애환자안수궤수자표법분위대조조、NMES조화강화NMES조,매조10례.3조환자균급여상규탄인공능훈련,NMES조화강화NMES조재차기출상보이신경기육저빈전자격,NMES조매일1차,강화NMES조매일2차.치료전、치료2주급4주후채용와전음수시험화시빈투시탄인검사(VFSS)대료효진행평정.결과 치료2주후,강화NMES조치료현효솔명현고우대조조,차이유통계학의의(P＜0.05);치료2주후,각조환자VFSS평분균교치료전증고(P＜0.05);여대조조치료2주후비교,NMES조[(8.100±1.287)분]화강화NMES조[(9.000±0.943)분]VFSS평분균고우대조조[(7.200±1.814)분](P＜0.05),차강화NMES조VFSS평분고우NMES조(P＜0.05).결론 NMES가명현제고뇌졸중환자적탄인반사수평급인부기육적수축공능,증강탄인재학습적훈련료효,재탄인공능훈련기출상,강화NMES적료효우우NMES.
Objective To observe the effects of neuromuscular stimulation (NMES) intensity on post-stroke dysphagia.Methods Thirty patients with dysphagia resulting from a stroke were randomly divided into a control group,an NMES group,and an intensive NMES group,with 10 patients in each.The 3 groups all received conven-tional swallowing training.Patients in the NMES group also received NMES once a day and those in the intensive NMES group received it twice a day.Kubota's water drinking test and videofluoroscopy were used to assess the subjects' swallowing function before treatment and after 2 and 4 weeks of treatment.Results After 2 weeks,the average water drinking test score was significantly better in the intensive NMES group than in the control group.The fluoroscopic results of all three groups had improved significantly,but the results in the NMES group and the intensive NMES group were significantly better than those of the control group.The intensive NMES group also scored significantly higher than the NMES group.Conclusion NMES can improve the swallowing reflex and the contraction of the suprahyoid muscles.It can strengthen the effect of re-learning swallowing.Two NMES sessions a day are better than one.
