低频脉冲电刺激联合呼吸肌训练治疗脑卒中后吞咽障碍的效果

Effect of Low Frequency Pulse Electrical Stimulation Combined with Respiratory Muscle Training in the Treatment of Dysphagia after Stroke

目的:观察低频脉冲电刺激联合呼吸肌训练治疗脑卒中后吞咽障碍的效果。方法:选取2019年1月—2021年1月合肥市第二人民医院80例脑卒中后吞咽障碍患者作为研究对象。根据随机数表法将其分为观察组和对照组,各40例。两组均给予对症综合治疗,对照组给予呼吸肌训练,观察组在对照组的基础上给予低频脉冲电刺激治疗。比较两组治疗4周后临床疗效,治疗前、治疗4周后吞咽造影检查(VFSS)指标、洼田饮水试验评分、Barthel指数及血液流变学指标。结果:治疗4周后,观察组临床疗效优于对照组,治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组舌骨前移、舌骨上移、甲状软骨前移、甲状软骨上移距离均较治疗前增加,且观察组舌骨前移、舌骨上移、甲状软骨前移、甲状软骨上移距离均大于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组洼田饮水试验评分较治疗前降低,Barthel指数评分较治疗前升高,且观察组洼田饮水试验评分低于对照组,Barthel指数评分高于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组血浆黏度、全血高切黏度、全血低切黏度均较治疗前降低,且观察组血浆黏度、全血高切黏度、全血低切黏度均低于对照组,差异有统计学意义(P<0.05)。结论:低频脉冲电刺激联合呼吸肌训练治疗脑卒中后吞咽障碍可改善血液流变学状态,利于吞咽功能恢复。

Objective:To observe the effect of low frequency pulse electrical stimulation combined with respiratory muscle training in the treatment of dysphagia after stroke.Method:From January 2019 to January 2021,80 patients with dysphagia after stroke in the Second People's Hospital of Hefei were selected as the research objects.According to the random number table method,they were divided into observation group and control group,40 cases in each group.Both groups were given symptomatic comprehensive treatment,the control group was given respiratory muscle training,and the observation group was given low frequency pulse electrical stimulation on the basis of the control group.The clinical efficacy after 4 weeks of treatment,video fluoroscopic swallowing study(VFSS)index,water swallow test score,Barthel index and hemorheology index before and after 4 weeks of treatment were compared between the two groups.Result:After 4 weeks of treatment,the clinical efficacy of the observation group was better than that of the control group,and the total effective rate of treatment was higher than that of the control group,and the differences were statistically significant(P<0.05).After 4 weeks of treatment,hyoid bone move forward,hyoid bone move up,thyroid cartilage move forward,and thyroid cartilage move up distances in the two groups were increased compared with those before treatment,and the hyoid bone move forward,hyoid bone move up,thyroid cartilage move forward,and thyroid cartilage move up distances in the observation group were greater than those in the control group,and the differences were statistically significant(P<0.05).After 4 weeks of treatment,the scores of water swallow test in the two groups were lower than those before treatment,and the scores of Barthel index were higher than those before treatment,and the score of water swallow test in the observation group was lower than that in the control group,and the score of Barthel index was higher than that in the control group,and the differences were statistically significant(P<0.05).After 4 weeks of treatment,the plasma viscosity,whole blood high shear viscosity and whole blood low shear viscosity of the two groups were lower than those before treatment,and the plasma viscosity,whole blood high shear viscosity and whole blood low shear viscosity of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Low frequency pulse electrical stimulation combined with respiratory muscle training can improve the hemorheological status and facilitate the recovery of swallowing function in the treatment of dysphagia after stroke.