吞咽训练结合吞咽电刺激治疗帕金森重度吞咽障碍患者的疗效观察

VitalStim electrical stimulation combined with traditional swallowing therapy alleviates dysphagia among Parkinson′s patients

目的观察常规吞咽训练联合吞咽电刺激治疗帕金森重度吞咽障碍患者的疗效。方法采用随机分组软件将36例帕金森重度吞咽障碍患者分为观察组及对照组。对照组给予常规吞咽训练,观察组给予吞咽电刺激及常规吞咽训练。于治疗前、治疗15 d后分别采用改良曼恩吞咽功能评估量表(MMASA)、标准吞咽功能评定量表(SSA)对2组患者吞咽功能进行评定。结果治疗后对照组MMASA评分[(62.0±8.2)分]较治疗前无明显改变(P>0.05),SSA评分[(28.2±4.0)分]较治疗前明显下降(P<0.05);观察组MMASA评分[(77.9±12.6)分]、SSA评分[(32.9±3.6)分]均较治疗前及对照组明显改善(P<0.05);治疗后观察组患者拔管率(47.1%)明显优于对照组(15.8%),组间差异具有统计学意义(P<0.05)。结论吞咽电刺激联合常规吞咽训练对帕金森重度吞咽障碍患者具有显著疗效,该联合疗法值得临床进一步研究、推广。

Objective To investigate the effect of VitalStim electrical stimulation combined with traditional swallowing therapy on severe dysphagia in patients with Parkinson′s disease(PD).Methods In all,36 PD patients with severe dysphagia were randomly divided into a treatment group and a control group,each of 18.Both groups were given the traditional swallowing therapy,while the treatment group was additionally provided with VitalStim electrical stimulation.Before and 15 days after the intervention,both groups were assessed using the modified Mann assessment of swallowing ability(MMASA)and standardized swallowing assessment(SSA).Results After the intervention the average SSA score of the control group had dropped significantly,but no significant change was observed in their average MMASA score.However,significant improvement was observed in both the average MMASA score and the average SSA score of the treatment group.Moreover,the cure rate of the treatment group was 47.1%,significantly higher than that of the control group.Conclusion VitalStim electrical stimulation combined with traditional swallowing therapy is effective for alleviating severe dysphagia among PD patients.It is worthy of application and further study in clinical practice.