呼吸肌训练联合肌电生物反馈训练对喉癌术后吞咽功能及吸入性肺炎的影响

Effect of respiratory muscle training combined with electromyography biofeedback training on swallowing function and aspiration pneumonia in patients with laryngocarcinoma after operation

目的探讨呼吸肌训练联合肌电生物反馈训练对喉癌喉切除术后患者的吞咽功能的影响,评估该康复治疗对喉癌喉切除术后吞咽障碍患者吞咽功能训练的价值;通过有效科学数据对该患者的康复及相关治疗能否有效减少吸入性肺炎发生进行分析。方法通过将2015年1月~2018年3月在我院治疗的64例喉癌术后吞咽障碍患者随机分组,分为A、B、C三组,A组22例接受常规吞咽功能训练,B组21例接受肌电生物反馈训练联合常规吞咽功能训练,C组21例接受呼吸肌训练和肌电生物反馈训练、常规吞咽功能训练。运用表面肌电图采集舌骨上肌群肌电积分值(iEMG)及洼田饮水实验评估吞咽障碍的疗效;采用吸入性肺炎诊断标准判断吸入性肺炎发生情况。结果在研究终点,三组患者舌骨上肌群肌电积分值均较治疗前提高(P <0.05);其中C组的提高幅度更为明显,优于B组和A组,组间差异有统计学意义(P <0.05)。在研究终点,A、B和C三组吸入性肺炎的发生率分别为30.00%、20.00%和5.00%,三组的组间差异及治疗有效率差异均有统计学意义(P <0.05)。结论呼吸肌训练联合肌电生物反馈训练可改善喉癌术后吞咽障碍患者的吞咽功能,可有效降低吸入性肺炎的发生率。

Objective To discuss the effect of the respiratory muscle training combined with the electromyography biofeedback training on the swallowing function of patients with laryngocarcinoma after operation, and to evaluate the value of the rehabilitation therapy on swallowing function training for patients with dysphagia. And to verify the rehabilitation and related treatment can effectively reduce the incidence of aspiration pneumonia through effective scientific data. Methods Sixty-four dysphagia patients with laryngoearcinoma after operation in our hospital from January 2015 to March 2018 were randomly divided into three groups. Twenty-two patients of the group A received routine swallowing training, twenty-one patients of the group B received electromyographic biofeedback training combined with the conventional swallowing training, and twenty-one patients of the group C received respiratory muscle training and eleetromyographie biofeedback training, routine swallowing function training. The surface eleetromyography was used to collect the integral value of the hyoid muscle group（iEMG） and Sumida drinking water test to evaluate the efficacy of dysphagia, and the diagnostic criteria of inhalation pneumonia was used to determine the incidence of inhalation pneumonia. Results At the end of the study, the integral value of the hyoid muscle group in the three groups was higher than that before the treatment（P 〈 0.05）, and the increase in the group C was more obvious than that of the group B and the group A, there was significant difference between these three groups （P 〈 0.05）. At the end of the study, the incidence of inhalation pneumonia in the three groups of the A, B and C were 30.00%, 20.00% and 5.00% respectively. The total effective rate of the three groups and the difference between them were statistically significant（P 〈 0.05）. Conclusion The respiratory muscle training combined with electromyography biofeedback training can improve the swallowing function of the patients with laryngocarcinoma after operation, and it can also reduce the incidence of inhaled pneumonia effectively.