舌内外肌群低频脉冲电刺激治疗鼻咽癌放疗后舌运动障碍的疗效观察

目的 探讨用手持棒式电极对鼻咽癌放疗后患者的舌内外肌群进行低频脉冲电刺激，观察对舌运动障碍的临床疗效。 方法 选取鼻咽癌放疗后舌肌运动障碍患者60例，按随机数字表法分为舌内外肌组和舌外肌组，每组30例，其中17例患者因病情、经济及家庭原因不能坚持治疗，退出研究。最后纳入统计的患者资料43例，其中舌内外肌组22例，舌外肌组21例。2组患者均采用感应电疗法，手持棒式电极刺激治疗，舌内外肌组刺激部位为舌内外肌群，每次治疗20min;舌外肌组刺激部位为舌外肌群，每次治疗15min。治疗时间均为每日1次，每周5d，共治疗4周。分别于治疗前和治疗4周后，对2组患者进行舌肌运动范围测量，记录和统计分析2组患者舌的前伸运动、左右运动及上下运动范围。 结果 治疗前，2组患者舌前伸运动、左右运动、上下运动范围比较，差异均无统计学意义(P>0.05)。治疗后，2组患者的舌前伸运动较组内治疗前明显改善(P<0.05)，且舌内外肌组较舌外肌组改善更为明显，组间差异有统计学意义(P<0.05)；舌内外肌组治疗后的舌左右运动范围较治疗前有明显改善(P<0.05)，而舌外肌组较治疗前差异无统计学意义（P>0.05）；2组患者治疗后的舌上下运动范围较治疗前差异均无统计学意义（P>0.05）。 结论 手持棒式电极感应电疗法能有效针对舌肌运动障碍患者的舌内、外肌进行治疗，改善患者的舌前伸运动和舌左右运动。

Effects of low frequency pulsed electrical stimulation on tongue muscles in nasopharyngeal carcinoma patients after radiotherapy

Objective To study the effect of low frequency electric stimulation on tongue muscles in nasopharyngeal carcinoma (NPC) patients after radiation therapy. Methods Forty-three nasopharyngeal carcinoma patients with dysphagia after radiation therapy were randomly divided into a control group of 21 and a test group of 22. The control group received low frequency electric stimulation on external tongue muscles for 15 minutes a day while the test group received low frequency electric stimulation on external tongue muscles for 20 minutes a day, 5 days a week for 4 weeks. Before and after the treatment, the range of motion of tongues was evaluated. Results Before the treatment, there was no significant difference between the two groups in all the measurements (P>0.05). After the treatment, the protraction of the tongue improved significantly in both groups, with a significantly more improvement in the test group than in the control group. Significant improvement was observed in the side-to-side movement of the tongue in the test group, but not in the control group after the treatment. However, no significant improvement was observed in the up-and-down motion of the tongue in both groups after the treatment (P>0.05). Conclusion Low frequency electric stimulation on internal and external tongue muscles can improve the protractive and side-to-side motion of the tongue in NPC patients after radiotherapy.