神经肌肉电刺激联合吞咽康复训练治疗脑卒中后吞咽障碍的疗效及其对舌骨喉复合体动度的影响

目的 探讨神经肌肉电刺激联合吞咽康复训练治疗脑卒中后吞咽障碍的疗效及其对舌骨喉复合体动度的影响。 方法 选取2016年1月—2017年1月晋中市第一人民医院的脑卒中后吞咽障碍患者56例，随机分为观察组和对照组，每组各28例。观察并比较2组患者的一般资料、洼田饮水试验结果、才藤分级、VFSS吞咽功能障碍评分及舌骨喉复合体动度。 结果 经治疗后，2组患者洼田饮水试验分级结果均较治疗前显著提高(P<0.05)，且观察组洼田饮水试验分级显著高于对照组(P<0.05)。经洼田饮水试验结果分析，观察组的显效率显著高于对照组(P<0.05)。2组患者治疗后才藤分级结果均较治疗前显著提高(P<0.05)，且观察组才藤分级结果显著高于对照组(P<0.05)。经才藤分级结果显示，观察组的有效率显著高于对照组有效率(P<0.05)。2组患者治疗后VFSS吞咽功能障碍评分均较治疗前显著提高(P<0.05)，且观察组VFSS吞咽功能障碍评分显著高于对照组(P<0.05)。在吞咽半流质食物时，观察组患者治疗后舌骨前移距离和舌骨上移均明显增加(P<0.05)。观察组治疗前后吞咽时甲状软骨动度比较差异无统计学意义(P>0.05)。对照组治疗前、后吞咽时舌骨动度及甲状软骨动度比较差异均无统计学意义(均P>0.05)。 结论 NMES联合吞咽功能训练可有效改善患者脑卒中后吞咽障碍的临床症状，提高颏舌骨肌和下颌舌骨肌肌力，有效恢复吞咽功能。 

Effect of neuromuscular electrical stimulation combined with swallowing rehabilitation training on post-stroke dysphagia and its effect on movement of the hyo-laryngeal complex

Objective To evaluate the effect of neuromuscular electrical stimulation combined with swallowing rehabilitation on post-stroke dysphagia and its effect on movement of the hyo-laryngeal complex. Methods Total 56 patients with post-stroke dysphagia from January,2016 to January,2017 were randomly divided into observation group and control group(n=28).The general data,results of the drinking water test,grapevine grade,VFSS swallowing dysfunction score,and hyoid and laryngeal complex of the two groups were observed and compared. Results After the treatment,the results of the drinking water test in the two groups were significantly higher than those before the treatment(P<0.05),and the water level of the observation group was significantly higher than that of the control group(P<0.05).The effective rate of the observation group was significantly higher than that of the control group(P<0.05).The results of the two groups were significantly higher than those before treatment(P<0.05),and the results of the observation group were significantly higher than those of the control group(P<0.05).The effective rate of the observation group was significantly higher than that of the control group(P<0.05).The scores of VFSS swallowing dysfunction were significantly improved in both groups after the treatment(P<0.05),and the score of VFSS swallowing dysfunction in the observation group was significantly higher than that in the control group(P<0.05).When the diet was swallowed,the distance between the hyoid bone and the uplift of the hyoid were significantly increased in the observation group(P<0.05).There was no significant difference in the movement of thyroid cartilage before and after the treatment in the observation groups(P>0.05).There was no significant difference in the movement of hyoid bone and thyroid cartilage before and after the treatment in the control group(P>0.05). Conclusion NMES combined with swallowing function can improve the clinical symptoms of dysphagia after stroke and the muscle strength of the mylohyoid and geniohyoid muscle,and effectively restore the swallowing function.