吞咽神经肌肉电刺激对急性脑梗死后吞咽功能障碍患者吞咽功能和营养状况的影响

Effects of swallowing neuromuscular electrical stimulation on swallowing function and nutritional status of patients with dysphagia after acute cerebral infarction

目的探究吞咽神经肌肉电刺激对急性脑梗死(ACI)后吞咽功能障碍患者吞咽功能、营养状况的影响。方法选取89例ACI后吞咽功能障碍患者作为研究对象,采用随机数字表法将其分为对照组(44例)和观察组(45例)。对照组行常规吞咽功能康复训练,观察组在对照组的基础上行吞咽神经肌肉电刺激,两组均治疗30 d。比较两组患者治疗前后的咽喉部肌肉活动度、吞咽功能和营养状况。结果干预前,两组患者的咽喉部肌肉肌电图最大波幅差异无统计学意义(P>0.05)。干预30 d后,观察组患者咽喉部肌肉肌电图最大波幅高于对照组(P<0.05)。干预前,两组患者的进食评估问卷工具(EAT)-10、洼田饮水试验评分差异均无统计学意义(均P>0.05)。干预30 d后,观察组的EAT-10、洼田饮水试验评分均低于对照组(均P<0.05)。干预前,两组患者的血清白蛋白、总胆固醇、三酰甘油水平和体质量指数差异均无统计学意义(均P>0.05)。干预30 d后,观察组的血清白蛋白、总胆固醇、三酰甘油水平和体质量指数均高于对照组(均P<0.05)。结论常规吞咽功能康复训练联合吞咽神经肌肉电刺激对ACI后吞咽功能障碍患者干预效果明显,可有效地提高咽喉部肌肉活动度,提升吞咽功能,进而改善营养状况。

Objective To explore the effects of swallowing neuromuscular electrical stimulation on swallowing function and nutritional status of patients with dysphagia after acute cerebral infarction(ACI).Methods A total of 89 patients with dysphagia after ACI were selected as the research objects,and they were divided into a control group(44 cases)or an observation group(45 cases)by the random number table method.The control group received routine swallowing function rehabilitation training,based on which the observation group received additional swallowing neuromuscular electrical stimulation.Both groups were treated for 30 days.The pharyngolaryngeal muscle activity,swallowing function and nutritional status of the two groups were compared before and after treatment.Results Before intervention,there was no statistically significant difference in the maximum amplitude of pharyngolaryngeal muscle electromyography between the two groups(P>0.05).After 30 days of intervention,the maximum amplitude of pharyngolaryngeal muscle electromyography in the observation group was higher than that in the control group(P<0.05).Before intervention,there was no statistically significant difference between the two groups in Eating Assessment Tool(EAT)-10 or Kubota water drinking test score(all P>0.05).After 30 days of intervention,the EAT-10 and Kubota water drinking test scores of the observation group were lower than those of the control group(all P<0.05).Before intervention,there was no statistically significant difference in serum albumin,total cholesterol or triacylglycerol level or body mass index between the two groups(all P>0.05).After 30 days of intervention,the serum albumin,total cholesterol,triacylglycerol levels and body mass index in the observation group were higher than those in the control group(all P<0.05).Conclusion Routine swallowing function rehabilitation training combined with swallowing neuromuscular electrical stimulation has an obvious intervention effect on patients with dysphagia after ACI,which can effectively improve the pharyngolaryngeal muscle activity,swallowing function and nutritional status.