低频感应电联合呼吸训练对脑卒中后鼻饲患者吞咽功能及拔管进程影响研究

Efficacy of low-frequency induction plus breathing training on swallowing function and extubation process in patients with nasal feeding after stroke

目的:观察低频感应电刺激联合呼吸训练对脑卒中后鼻饲患者吞咽功能及拔管进程影响。方法:93例脑卒中恢复期鼻饲饮食患者随机分为A组31例(常规吞咽基础训练),B组31例(A组基础上配合低频电刺激),C组31例(B组基础上配合呼吸训练),治疗前及疗程结束后运用洼田氏饮水试验、Rosenbek误吸程度分级,X线透视吞咽功能(Video Fluoroscopic Swallowing Study,VFSS)、表面肌电图(Surface Electromyography,sEMG)系统评价三组患者吞咽功能改善情况,并比较三组患者拔管时间差异。结果:治疗结束后与治疗前比较三组患者洼田饮水试验评分、VFSS评分及Rosenbek误吸程度分级明显改善(P<0.05),与A、B组治疗后比较C组改善更加明显(P<0.05)。治疗结束后与治疗前比较三组患者吞咽时间较治疗前均缩短,sEMG最大波幅值明显升高(P<0.05),与A、B组比较C组降幅更加明显(P<0.05)。与A、B组比较C组患者拔除鼻饲管时间明显缩短(P<0.05)。结论:低频感应电联合呼吸训练可有效改善脑卒中患者吞咽功能,减短患者拔除鼻饲管时间,促进患者康复,值得临床推广。

Objective:To observe efficacy of low-frequency induction electrical stimulation plus breathing training on swallowing function and extubation process in patients with nasal feeding after stroke.Methods:93 patients were randomly divided into group A(31 cases,receiving routine basic swallowing training),and the group B(31 cases,receiving low frequency stimulation plus routine basic swallowing),and the group C(31 cases,receiving respiratory training more).Results:After treatment,the Watian Drinking Water Test score,VFSS score and Rosenbek Mistake Degree Grading in the three groups were more improved than before treatment(P<0.05),and the improvement in group C was most obvious(P<0.05).After treatment,the swallowing time in three groups was shorter,and the maximum amplitude of sEMG was significantly higher than before treatment(P<0.05).Those was most obvious in group C(P<0.05).Compared with group A and B,the time of withdrawing nasal feeding tube in group C was significantly shorter(P<0.05).Conclusion:Low-frequency induction plus breathing training can effectively improve the swallowing function of stroke patients,shorten the time of removal of nasal feeding tube,and promote the rehabilitation,which is worthy of clinical promotion.