舌压抗阻反馈训练应用于脑卒中后吞咽障碍患者的临床效果研究

Clinical Effect of Tongue Pressure Resistance Feedback Training on Patients with Dysphagia after Stroke

目的探讨舌压抗阻反馈训练应用于脑卒中后吞咽障碍(DAS)患者的临床效果.方法选取2019年10月-2021年10月于该院接受治疗的60例DAS患者,按便利抽样法分为C组和O组,各30例.所有患者接受常规护理、康复管理和吞咽神经肌肉电刺激治疗,在此基础上,C组进行空白动作训练,O组接受舌压抗阻反馈训练.对比两组治疗前、治疗3周结束后的舌压、舌骨表面肌电(sEMG)、吞咽功能、进食能力、吞咽生存质量及并发症.结果治疗3周结束后,O组的舌压峰值、舌压平均值、sEMG最大波幅值均高于C组,舌压持续时间长于C组,吞咽障碍程度评分高于C组,Rosenbek渗透-误吸量表评分低于C组,经口摄食功能量表分级优于C组,吞咽障碍特异性生活质量量表评分高于C组,组间差异有统计学意义(P<0.05).两组并发症发生率对比,差异无统计学意义(P>0.05).结论舌压抗阻训练通过提高DAS患者的舌压、肌力改善其吞咽功能,提高进食能力,并显著改善患者的吞咽生存质量,但在减少吞咽相关并发症方面的效果有限.

Objective To explore the clinical effect of tongue pressure resistance feedback training on patients with dysphagia after stroke(DAS).Methods 60 patients with DAS who were treated in the hospital from October 2019 to October 2021 were selected and they were divided into group C and group O according to the convenient sampling method,with 30 cases in each group.All patients received routine nursing,rehabilitation management and swallowing neuromuscular electrical stimulation.On this basis,group C received blank movement training,and group O received tongue pressure resistance feedback training.Tongue pressure,hyoid surface electromyography(sEMG),swallowing function,eating ability,quality of life before treatment and after 3 weeks of treatment and complications were compared between the two groups.Results After 3 weeks of treatment,the peak value of tongue pressure,the average value of tongue pressure and the maximum amplitude of sEMG in group O were higher than those in group C,and the duration of tongue pressure was longer than that in group C,the severity of dysphagia score was higher than that in group C,and the Rosenbek's penetrationaspiration scale score was lower than that in group C,the functional oral feeding scale grading was better than that of group C,the swallowing disorder specific quality of life scale score was higher than that in group C,with statistically significant differences between groups(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The tongue pressure resistance training can improve the swallowing function,improve the eating ability and significantly improve the quality of life of patients with DAS by improving the tongue pressure and muscle strength,but it has limited effect in reducing swallowing related complications.