肌电生物反馈疗法治疗脑卒中后吞咽障碍的临床观察

Effect of electromyographic biofeedback therapy on dysphagia in stroke patients

目的观察肌电生物反馈治疗（EMGBFT）对脑卒中后吞咽障碍的疗效。方法将53例脑卒中后吞咽障碍的患者按病历号奇偶数排序，随机分为肌电生物反馈组及对照组。肌电生物反馈组26例，男16例，女10例，年龄42～85岁，其中病灶基底核区18例、枕叶4例、脑干4例，脑出血7例，脑梗死19例，有14例留置鼻饲管；对照组27例，男15例，女12例，年龄44～79岁，其中病灶基底核区16例、枕叶6例、脑干5例，脑出血11例，脑梗死16例，有13例留置鼻饲管。肌电生物反馈治疗组给予肌电生物反馈及电刺激治疗和吞咽训练治疗，对照组则给予电刺激治疗和吞咽训练治疗。于治疗前及治疗30d后采用洼田饮水试验分别对2组患者进行吞咽功能评定。结果治疗后2组患者吞咽功能均较治疗前有改善（P〈0．05），生物反馈组的治疗有效率为76．92％，对照组的总有效率为55．56％；生物反馈组的吞咽功能改善幅度较显著，优于对照组，组间差异有统计学意义（P〈0．05）；2组患者治疗前、后吞咽评级显示生物反馈组吞咽功能改善好于对照组（P〈0．05），差异有统计学意义。结论吞咽障碍患者在常规康复训练的基础上进行生物反馈训练，能明显提高患者的吞咽功能。

Objective To observe the effect of electromyographic biofeedback therapy （EMGBFT） on dysphagia in stroke patients. Methods Fifty-three stroke patients with dysphagia were divided randomly into an EMGBFT group and a control group. The patients of EMGBFT group were given EMGBFT,electrical stimulation therapy （EST） and dysphagia training, while those in the control group were given EST and dysphagia training. All the pa- tients were assessed with Kubota drinking test before treatment and 30 days after treatment. Results After treatment swallowing function of patients in both groups improved （P 〈 0.05 ）. The effective rate was 76.92% in EMGBFT group and 55.56% in control group, with statistically significant difference between the two groups （P 〈 0.05 ）. It showed that the EMGBFT group has significantly better outcome than the control group after treatment （ P 〈 0.05 ）. Conclusions EMGBFT combined with regular rehabilitation therapy can improve patient＇s motor and swallowing function.