NMES疗法及单纯吞咽训练对脑卒中后吞咽障碍的疗效观察

目的分析脑卒中后吞咽障碍患者采用神经肌肉电刺激疗法(NMES)联合单纯吞咽训练治疗的疗效。方法选取本科2013年1月至2015年1月的脑卒中后吞咽障碍患者90例,随机分为NMES联合治疗组和常规单纯运动训练组,常规单纯运动训练组予以单纯吞咽功能训练,NMES联合治疗组在常规单纯运动训练组基础上加用NMES疗法。对比两组患者治疗前后的各项吞咽功能评分和临床疗效。结果治疗3个疗程后,NMES联合治疗组和常规单纯运动训练组的洼田饮水试验分级、口面运动功能评分显著低于治疗前,吞咽X线电视透视检查(VFSS)评分、藤岛一郎吞咽疗效评分显著高于治疗前(P0.05);治疗3个疗程后,NMES联合治疗组的洼田饮水试验、口面运动功能评分显著低于对照组,VFSS评分、藤岛一郎吞咽疗效评分显著高于常规单纯运动训练组(P0.05)。治疗3个疗程后,NMES联合治疗组的总有效率为95.55%(43/45)显著高于常规单纯运动训练组77.78%(35/45)(P0.05)。结论对于脑卒中后吞咽障碍患者单纯吞咽训练联合采用NMES疗法,疗效更佳。

Efficacy of NMES therapy and swallowing training alone for dysphagia after stroke

Objective To analyze the therapeutic effect neuromuscular electrical stimulation therapy ( NMES) combined with swallowing training alone for patients with dysphagia after stroke.Methods 90 patients of dysphagia after stroke in our department from January 2013 to January 2015were randomly divided into NMES combined treatment group and routine simple exercise training group.The routine simple exercise training group was given a simple swallowing function training.The NMES combined treatment group used NMES therapy based on the routine simple exercise training group.The swallowing function scores before and after treatment and clinical efficacy of the two groups of patients were compared.Results After three courses of treatment, Kubota water test grade, orofacial motor function scores were significantly lower than before treatment, VFSS score, Fujishima Ichiro swallowing effect score in the NMES combined treatment group and the routine simple exercise training group was significantly higher than those before treatment, (P<0.05).After three courses of treatment, Kubota water test, orofacial motor function scores in the NMES combined treatment group were significantly lower than the routine simple exercise training group, VFSS score, Fujishima Ichiro swallowing effect score significantly higher, ( P<0.05) .After three courses of treatment, total effective rate of the NMES combined treatment group was 95.55%(43/45),which was significantly higher than 77.78%(35/45), (P<0.05).Conclusion For patients with dysphagia after stroke,a combination of NMES therapy and simple swallowing training has better effect.