神经肌肉电刺激疗法对脑卒中吞咽困难与周围性面瘫的治疗作用

Neuromuscular Electrical Stimulation Therapy for Post-stroke Disphagia and Peripheral Facial Paralysis

目的:探讨神经肌肉电刺激疗法(NMES)对卒中后吞咽困难(PSD)与周围性面瘫(PFP)治疗的有效性。方法:发病<14d的PSD患者102例,分为A1组58例和A2组44例;发病<7d的PFP患者92例,分为B1组49例和B2组43例。4组均按相关疾病给予对症药物治疗和功能训练,A1、B1组增加NMES电刺激治疗。A1、2组治疗前后采用洼田试验进行吞咽功能评分,并评定治疗后的临床疗效。B1、2组采用HBN量表进行面神经功能评分和临床疗效评定。结果:经过20d的治疗,A1组洼田试验评分及B1组HBN评分均分别较治疗前及A2、B2组明显提高(P<0.05);临床痊愈率及基本痊愈率均明显高于A2、B2组(69.0%、67.0%与36.0%、47.0%,P<0.05)。结论:NMES无论对中枢神经损伤还是周围神经损伤均有较好的治疗作用。

Objective：To discuss the clinical effectiveness of neuromuscular electrical stimulation（NMES）therapy for post-stroke disphagia（PSD）and peripheral facial paralysis（PFP）.Methods：102 PSD patients（disease course 14 days）were divided into A1 group（n=58）and A2 group（n=44）,and 92 cases of PFP（disease course 7 days）were divided into B1 group（n=49）and B2 group（n=43）.All patients were treated with corresponding medication and functional training.The patients in A1,and B1 groups were additionally subjected to NMES therapy.The patients in A1,and 2 groups were graded about the swallowing function with Bedside test before and after the therapy,and clinical effectiveness was assessed.The patients in B1,and 2 groups were graded about the facial function with HBN criteria and the clinical effectiveness was assessed.Results：After treatment for an average of 20 days,the Bedside test grade in A1 group and HBN grade in B1 group were significantly higher than those before treatment and those in A2,and B2 groups（P0.05）.The clinical recovery rate and the basic recovery rate were obviously higher in A1,and B1 groups than in A2,and B2 groups（69.0%,67.0% vs 36.0%,47.0%,P0.05）.Conclusion：NMES therapy has an excellent effect both in central nerve damage and peripheral nerve damage.