CAJ | 학술논문

目的观察针刺、神经肌肉电刺激、吞咽训练对脑卒中后吞咽障碍的疗效及对卒中后肺炎发生率的影响.方法伴有吞咽障碍的脑卒中患者分为:训练组(n=188),接受普通吞咽训练;电刺激组(n=196),接受神经肌肉电刺激及吞咽训练;综合组(n=112),接受中医针刺、神经肌肉电刺激及吞咽训练.比较治疗前及治疗后3周吞咽评分、肺炎发生率及国立卫生研究院卒中量表(NIHSS)评分的改善值,随访出院后3个月内新发肺炎发生率.结果治疗后,综合组吞咽障碍治疗有效率高于训练组(P<0.01)及电刺激组(P<0.05),治疗期间肺炎发生率低于训练组(P<0.01)及电刺激组(P<0.05),出院后3个月新发肺炎的发生率3组间无显著性差异(P>0.05);综合组NIHSS评分改善值高于训练组(P<0.01)及电刺激组(P<0.05).结论针刺、神经肌肉电刺激及吞咽训练联合治疗能明显改善脑卒中患者的吞咽功能,减少急性期肺炎发生率.
목적관찰침자、신경기육전자격、탄인훈련대뇌졸중후탄인장애적료효급대졸중후폐염발생솔적영향.방법반유탄인장애적뇌졸중환자분위:훈련조(n=188),접수보통탄인훈련;전자격조(n=196),접수신경기육전자격급탄인훈련;종합조(n=112),접수중의침자、신경기육전자격급탄인훈련.비교치료전급치료후3주탄인평분、폐염발생솔급국립위생연구원졸중량표(NIHSS)평분적개선치,수방출원후3개월내신발폐염발생솔.결과치료후,종합조탄인장애치료유효솔고우훈련조(P<0.01)급전자격조(P<0.05),치료기간폐염발생솔저우훈련조(P<0.01)급전자격조(P<0.05),출원후3개월신발폐염적발생솔3조간무현저성차이(P>0.05);종합조NIHSS평분개선치고우훈련조(P<0.01)급전자격조(P<0.05).결론침자、신경기육전자격급탄인훈련연합치료능명현개선뇌졸중환자적탄인공능,감소급성기폐염발생솔.
Objective To observe the effect of acupuncture, neuromuscular electrical stimulation and swallowing training on acute stroke patients with dysphagia and the incidence of post-stroke pneumonia (PSP). Methods Acute stroke patients with dysphagia were divid-ed into 3 groups. Routine group (n=188) received routine swallowing training. Stimulation group (n=196) received routine swallowing train-ing and neuromuscular electrical stimulation. Acupuncture group (n=112) received routine swallowing training, neuromuscular electrical stimulation, and acupuncture. The incidence of improvment of dysphagia and PSP, and the improvement of National Institutes of Health Stroke Scale (NIHSS) within 3 weeks were compared. They were followed up for 3 months for the incidence of PSP. Results The incidence of improvment of dysphagia was the most in the acupuncture group (P<0.05), while the incidence of PSP was the least (P<0.05). The im-provement of NIHSS was the most in the acupuncture group (P<0.05). The incidence of PSP was not significantly different (P>0.05) within 3 months followed up. Conclusion The acupuncture, neuromuscular electrical stimulation and swallowing training combination can improve the swallowing function and decrease the incidence of PSP in stroke patients with dysphagia.