重复经颅磁刺激结合舌压抗阻反馈训练对脑出血术后吞咽功能障碍患者脑干听觉诱发电位及误吸风险的影响

Effects of repetitive transcranial magnetic stimulation combined with tongue pressure resistance feedback training on brainstem auditory evoked potential and aspiration risk in patients with swallowing dysfunction after cerebral hemorrhage surgery

目的探讨重复经颅磁刺激结合舌压抗阻反馈训练在脑出血术后吞咽功能障碍患者中的应用效果。方法选择2019年7月至2021年8月我院收治的80例脑出血术后吞咽功能障碍患者,根据干预方案不同将其分为对照组、观察组,各40例。对照组接受舌压抗阻反馈训练,观察组在对照组干预方案基础上加施重复经颅磁刺激。比较两组的干预效果。结果干预后,观察组的脑干听觉诱发电位(BAEP)Ⅰ波、Ⅲ波、Ⅴ波潜伏期均短于对照组(P<0.05)。干预后,观察组的渗透-误吸量表(PAS)等级分布优于对照组(P<0.05)。干预后,观察组的功能性经口摄食量表(FOIS)评分高于对照组,标准吞咽功能评估量表(SSA)评分低于对照组(P<0.05)。结论重复经颅磁刺激结合舌压抗阻反馈训练可改善脑出血术后吞咽功能障碍患者BAEP及吞咽功能,减少误吸的发生风险。

Objective To explore the application effect of repetitive transcranial magnetic stimulation combined with tongue pressure resistance feedback training in patients with swallowing dysfunction after cerebral hemorrhage surgery.Methods Eighty patients with swallowing dysfunction after cerebral hemorrhage surgery admitted in our hospital from July 2019 to August 2021 were selected and divided into control group and observation group according to the different intervention schemes,with 40 cases in each group.The control group received tongue pressure resistance feedback training,and the observation group received repetitive transcranial magnetic stimulation on the basis of the intervention program of the control group.The intervention effects of the two groups were compared.Results After intervention,the latency ofⅠwave,Ⅲwave andⅤwave of brainstem auditory evoked potential(BAEP)in the observation group were shorter than those in the control group(P<0.05).After intervention,the grade distribution of Penetration-Aspiration Scale(PAS)in the observation group was better than that in the control group(P<0.05).After intervention,the score of Function Oral Intake Sccale(FOIS)in the observation group was higher than that in the control group,and score of Standardized Swallowing Assessment(SSA)was lower than that in the control group(P<0.05).Conclusion Repetitive transcranial magnetic stimulation combined with tongue pressure resistance feedback training can improve BAEP and swallowing function in patients with swallowing function after cerebral hemorrhage surgery,and reduce aspiration risk.