激光星状神经节照射联合经皮神经电刺激治疗脑卒中后吞咽障碍的疗效观察

目的：观察激光星状神经节照射配合经皮神经电刺激治疗脑卒中吞咽障碍的临床疗效。方法：脑卒中吞咽障碍患者100例随机分为A组33例、B组33例及C组34例,A组接受常规神经内科治疗及冰刺激疗法,B组在A组治疗基础上给予经皮神经电刺激疗法,C组在B组治疗基础上增加激光照射星状神经节。分别于治疗前后采用洼田饮水试验对3组患者进行吞咽功能评定,并比较总疗效和胃管留置率的变化情况。结果：治疗4周后,3组患者吞咽功能均较治疗前明显改善（P〈0.05）;且C组优于B组,B组优于A组,组间差异有统计学意义（P〈0.05）。治疗后3组临床疗效比较,C组总有效率高于B组,B组高于A组（94.12%、72.73%、36.36%,P〈0.05）。A、B、C组的胃管留置率均较治疗前明显下降（30.30%、27.27%、41.18%和6.06%、3.03%、0,P〈0.05）,但组间差异无统计学意义。结论：吞咽障碍患者在冰刺激及经皮神经电刺激治疗的基础上辅以激光照射星状神经节治疗效果明显,能进一步提高患者的吞咽功能,明显降低胃管使用率。

Effect of super lizer stellate ganglion block and transcutaneous electrical nerve stimulation on dysphagia following stroke

Objective：To observe the clinical efficacy of combined therapy of super lizer stellate ganglion block（SGB）and transcutaneous electrical nerve stimulation（TENS）in the treatment of dysphagia following stroke.Methods：One hundred patients with dysphagia following stroke were divided randomly into three groups：group A（33cases）subjected to ice stimulation,group B（33cases）to TENS and ice stimulation,and group C（34cases）to super lizer SGB,TENS and ice stimulation.All the patients were assessed with Kubota drinking test before and 4weeks after treatment.The gastric retention rate and the total effective rate were recorded and statistically analyzed.Results：The swallowing function of patients in three groups was improved after treatment（P〈0.05）,and the therapeutic effective rate in group C was higher than in groups B and A,and that in group B higher than in group A（P〈0.05）.The clinical effective rate in groups A,B and C was 36.36%,72.73% and 94.12% respectively with the difference being statistically significant among three groups（P〈0.05）.The gastric retention rate in groups A,B and C was decreased significantly after treatment for 4weeks as compared with that before treatment（30.30%,27.27 % and 41.18% vs.6.06%,3.03% and 0,P〈0.05）,but there was no significant difference among the three groups.Conclusion：Combined therapy of super lizer SGB and TENS is effective to improve the swallowing function and reduce gastric retention rate of patients with dysphagia following stroke.