超激光照射星状神经节阻滞疗法联合肌电生物反馈治疗脑卒中后吞咽障碍的疗效观察

Observation of Curative Effect of Ultra-Laser Irradiation on Stellate Ganglia Combined with Electromyography Biofeedback in the Treatment of Dysphagia after Stroke

目的:探讨超激光照射星状神经节阻滞疗法联合肌电生物反馈训练对脑卒中吞咽障碍患者舌骨上肌群肌电积分值及胃管留置的影响。方法:选取2020年6月至2021年12月在成都体育学院附属体育医院运动医学康复科住院的脑卒中后恢复期吞咽障碍患者60例,按入院病历号依次编号,采用随机数字表法将患者分为常规组、肌电生物反馈组、联合组,每组20例。常规组接受常规吞咽功能训练,肌电生物反馈组在常规吞咽功能训练基础上增加肌电生物反馈训练,联合组在肌电生物反馈组基础上辅以超激光照射星状神经节阻滞治疗。分别于治疗前及治疗4周后采集3组患者的舌骨上肌群肌电积分值,记录胃管留置率,并进行统计学分析比较。结果:3组患者治疗后舌骨上肌群肌电积分值均较治疗前提高(P<0.05);联合组患者舌骨上肌群肌电积分值提高更为明显,优于肌电生物反馈组和常规组(P<0.05)。3组患者治疗后的胃管留置率均较治疗前有明显下降(P<0.05),以联合组下降尤为明显(P<0.05)。结论:脑卒中吞咽障碍患者在肌电生物反馈训练基础上辅以超激光照射星状神经节阻滞治疗可以显著改善吞咽功能,提高临床疗效,改善患者生活质量,该疗法值得临床推广及应用。

Objective:To study the effect of ultra-laser stellate ganglion block combined with electromyographic biofeedback training on swallowing function after stroke.Methods:sixty patients with dysphagia for stroke were divided randomly into three groups:the conventional group(20 cases)treated with swallowing function training,the EMG-BFT group(20 cases)treated with electromyographic biofeedback training,and the integrated group(20 cases)treated with ultra-laser stellate ganglion block and electromyographic biofeedback training.The iEMG of suprahyoid muscles was collected,the gastric retention rate was recorded before treatment and four weeks after treatment,and statistical analysis was performed comparing.Results:The iEMG of suprahyoid muscles of patients in three groups were better than pre-treatment(P<0.05),while the integrated group outweighed other groups,the difference was statistically significant(P<0.05).The gastric retention rate of patients in three groups were decreased significantly than pre-treatment(P<0.05)after four weeks,while the integrated group outweighed other groups(P<0.05).Conclusions:Combined therapy of ultra-laser stellate ganglion block and electromyographic biofeedback training is effective to improve the swallowing of stroke following dysphagia.