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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。
Objective To investigate the curative effect of neuromuscular electrical stimulation and swallowing rehabilitation training on post-stroke dysphagia and its effect on the hyoid-laryngeal complex. Methods From January 2016 to January 2017, 56 patients with post-stroke dysphagia in the First People’s Hospital of Jinzhong City were randomly divided into observation group and control group, 28 cases in each group. Observe and compare the general information of two groups of patients, Kubota drinking water test results, only rattan grading, VFSS swallowing dysfunction score and hyoidlaryngeal complex movement. Results After treatment, the grading results of Wuda drinking water test in two groups were significantly higher than those before treatment (P <0.05), and the drinking water test in Kubota of the observation group was significantly higher than that of the control group (P <0.05). By the Kubota drinking water test results, the observation group significantly higher efficiency than the control group (P <0.05). After treatment, the grading results of the two groups were significantly higher than those before treatment (P <0.05), and the grading results of the grapes in the observation group were significantly higher than those in the control group (P <0.05). According to the results of grading, the efficiency of the observation group was significantly higher than that of the control group (P <0.05). The VFSS swallowing dysfunction scores in both groups were significantly higher than those before treatment (P <0.05), and the VFSS swallowing dysfunction scores in the observation group were significantly higher than those in the control group (P <0.05). In swallowing semi-liquid food, the observation group patients after treatment of hyoid bone and hyoid shift were significantly increased (P <0.05). There was no significant difference in thyroid cartilage movement between observation group before and after swallowing (P> 0.05). The control group had no significant difference in hyoid dynamic and thyroid cartilage movement before and after swallowing (all P> 0.05). Conclusion NMES combined swallowing functional training can effectively improve the clinical symptoms of patients with swallowing disorders after stroke, improve the genioglossus and hyoid muscles, and effectively restore swallowing function.