神经肌肉电刺激联合吞咽训练治疗脑卒中后吞咽障碍的临床效果分析

目的探讨神经肌肉电刺激联合吞咽训练治疗脑卒中后吞咽障碍的临床效果。方法选择2009年1月～2013年10月来本院治疗的脑卒中后吞咽功能障碍患者165例,按照入院顺序分为观察组83例,采用神经肌肉电刺激联合吞咽训练治疗,对照组82例,单独采用吞咽训练治疗。比较两组sEMG最大波幅、SSA评分、VFSS评分及SWAL-QOL评分并分析其相关性。结果对照组及观察组治疗后sEMG最大波幅、VFSS评分均高于治疗前,SSA评分、SWAL-QOL评分均低于治疗前,差异有统计学意义（P〈0.05）,且观察组较对照组改善幅度更大,差异有统计学意义（P〈0.05）。sEMG负相关于SSA、SWAL-QOL,正相关于VFSS（P〈0.05）,SSA负相关于VFSS,正相关于SWAL-QOL（P〈0.05）,VFSS负相关于SWAL-QOL（P〈0.05）。结论神经肌肉电刺激联合吞咽训练治疗脑卒中后吞咽障碍能促进患者吞咽功能的恢复,可以在临床推广应用。

Analysis of the clinical effects of neuromuscular electrical stimulation combined swallowing training to treat dysphagia after stroke

Objective To investigate the clinical effect of the swallowing training joint neuromuscular electrical stimulation to treat dysphagia after stroke. Methods A total of 165 patients with swallowing dysfunction stroke were selected from Jan 2009 to Oct 2013 in our hospital, they were divided into two groups according to the order of admission, there were 83 cases in the observation group, which used neuromuscular electrical stimulation therapy combined with swallowing training, there were 82 cases in the control group treated by alone swallowing training therapy. The largest sEMG amplitude, SSA score, VFSS score and SWAL-QOL score of two groups were compared and its relevance was analyzed. Results The sEMG maximum amplitude, VFSS scores of The control group and the observation group after treatment were higher than before treatment, SSA score, SWAL-QOL scores were lower than before treatment, the difference was significant（P 0.05）, and the observation group after treatment with greater magnitude improvement than control group, the difference was significant（P〈0.05）. sEMG negative correlation with SSA, SWAL-QOL, and positive correlation with VFSS（P〈0.05）, SSA negative correlation with VFSS, and positive correlation with SWAL-QOL（P〈0.05）,VFSS negative correlation with SWAL-QOL（P〈0.05）. Conclusion Neuromuscular electrical stimulation combined conclusion after swallowing training in the treatment of stroke patients with dysphagia can promote the recovery of swallowing function and can be popularized in clinical application.