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目的探讨运用低频神经肌肉电刺激配合吞咽康复功能训练对脑卒中患者吞咽功能障碍的影响。方法选择2013年1月—2014年2月收治的60例脑卒中吞咽功能障碍患者作为研究对象,随机分为对照组和观察组各30例。对照组给予吞咽功能训练,观察组在对照组的基础上联合低频神经肌肉电刺激治疗。观察两组临床疗效并分别于治疗前与康复治疗后第15、30天进行吞咽造影检查(video fluoroscopic swallowing study,VFSS),比较VFSS评分变化情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组治疗后15、30 d VFSS评分分别为(8.49±0.31)、(9.12±0.05)分,均高于对照组的(5.05±0.12)、(5.38±0.13)分,差异均有统计学意义(均P<0.05)。观察组总有效率为96.67%,高于对照组的63.33%,差异有统计学意义(P<0.05)。结论低频神经肌肉电刺激能有效刺激外周神经,引起肌肉节律收缩,有助于肌纤维的代偿性增生,促进神经兴奋和传导功能的恢复,对脑卒中吞咽功能障碍的恢复具有积极的临床价值,值得进一步推广与运用。
Objective To explore the effects of low-frequency neuromuscular electrical stimulation combined with swallowing rehabilitation training on swallowing dysfunction in patients with stroke. Methods Sixty patients with swallowing dysfunction admitted to our hospital from January 2013 to February 2014 were selected as study subjects and randomly divided into control group and observation group of 30 cases. The control group was given swallowing functional training, and the observation group was treated with low-frequency neuromuscular stimulation on the basis of the control group. The clinical efficacy of the two groups were observed and video fluoroscopic swallowing study (VFSS) was performed before treatment and on the 15th and 30th day after rehabilitation, respectively. The changes of VFSS score were compared. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The VFSS scores of the observation group at 15 and 30 days after treatment were (8.49 ± 0.31) and (9.12 ± 0.05) points, respectively, which were significantly higher than those of the control group (5.05 ± 0.12 and 5.38 ± 0.13) Significance (all P <0.05). The total effective rate in observation group was 96.67%, which was higher than that in control group (63.33%), the difference was statistically significant (P <0.05). Conclusion Low-frequency neuromuscular electrical stimulation can effectively stimulate the peripheral nerves, cause muscle rhythm contraction, contribute to compensatory proliferation of muscle fibers, promote nerve excitability and recovery of conduction function, and have a positive clinical value for the recovery of swallowing dysfunction in stroke. Worth further promotion and use.