吞咽训练及冰刺激联合肌电生物反馈治疗在脑卒中吞咽呛咳患者中的应用效果

Application effect of swallowing training and ice stimulation combined with electromyography biofeedback therapy in stroke patients with swallowing and coughing

目的探讨吞咽训练及冰刺激联合肌电生物反馈治疗在脑卒中吞咽呛咳患者中的应用效果。方法选取79例脑卒中吞咽呛咳患者，采用随机数字表法分组，对照组39例给予常规吞咽训练干预，观察组40例于吞咽训练基础上实施冰刺激＋肌电生物反馈治疗，观察比较两组临床干预效果及干预前后吞咽功能（VFSS）评分，并统计两组并发症发生情况。结果观察组干预总有效率为90．00％（36／40），高于对照组的71．79％（28／39），差异有统计学意义（χ^2=4．255，P=0．039）；干预8周后观察组VFSS评分高于对照组，差异有统计学意义（t=12．173，P=0．000）；观察组并发症发生率为7．50％（3／40），低于对照组的25．64％（10／39），差异有统计学意义（χ^=4．727，P=0．030）。结论吞咽训练及冰刺激联合肌电生物反馈治疗可改善脑卒中吞咽呛咳患者吞咽功能，效果显著，安全性高。

Objective To investigate the application effect of swallowing training and ice stimulation combined with electromyography biofeedback therapy in stroke patients with swallowing and coughing. Methods Seventy - nine stroke swallowing and coughing patients treated were collected and were randomly divided into two groups （39 cases in control group,40 cases in observation group） according to the digital table. The control group was treated with normal swallowing training,while the observation group was treated with ice stimulation combined with electromyography biofeedback therapy. The clinical intervention effect and the VFSS results before and after the intervention were observed and compared. The complications of the two groups were statistically analyzed. Results The total effective rate of the observation group [90.00% （36/40） ] was higher than that of the control group[71.79% （28/39） ,χ^2 =4. 255 ,P = 0.039 ]. After eight - week intervention, the VFSS score of the observation group was higher than that of the control group （ t = 12. 173, P = 0.000） ; and the incidence rate of complications of the observation group [ 7.50% （3/40） ] was lower than that of the control group [ 25.64% （ 10/39）, χ^2 = 4. 727, P = 0. 030 ]. Conclusion Swallowing training and ice stimulation combined with electromyography biofeedback therapy can significantly improve the swallowing function of stroke patients with swallowing and coughing, and it is safe.