肌电生物反馈与电刺激治疗对急性出血性脑卒中后吞咽障碍患者临床疗效及吞咽功能的影响

The effect of electromyographic biofeedback and electrical stimulation therapy on clinical curative effect and swallowing function of patients with dysphagia after acute hemorrhagic stroke

目的探讨肌电生物反馈与电刺激治疗对急性出血性脑卒中(CVA)后吞咽障碍患者临床疗效及吞咽功能的影响。方法选取2018年2月至2022年2月我院收治的CVA后吞咽障碍患者91例,根据治疗方式不同分为对照组42例和观察组49例,对照组采取常规吞咽训练结合神经肌肉电刺激(NMES)疗法,观察组采取常规吞咽训练结合肌电生物反馈(EMGBF)疗法。比较两组治疗前后洼田饮水试验分级、临床疗效、表面肌电图(sEMG)检测结果、标准吞咽功能评定量表(SSA)及吞咽相关生活质量量表(SWAL-QOL)评分。结果与治疗前比较,两组洼田饮水试验法分级均明显改善,其中观察组改善效果更为显著(P<0.05);两组sEMG平均波幅均明显升高,吞咽时限缩短,其中观察组变化更为显著(P<0.05);观察组SSA评分低于对照组,SWAL-QOL评分高于对照组(P<0.05);观察组治疗后总有效率高于对照组(P<0.05)。结论EMGBF治疗急性出血性CVA后吞咽障碍患者临床疗效较NMES更明显,且能有效改善其吞咽功能,提高生活质量。

Objective To investigate the effects of electromyographic biofeedback(EMGBF)and electrical stimulation on clinical curative effect and swallowing function of patients with dysphagia after acute hemorrhagic cerebralvascular accident(CVA).Methods Ninety-one patients with dysphagia after acute hemorrhagic CVA treated in our hospital from February 2018 to February 2022 were selected.According to different treatment methods,the patients were divided into a control group(n=42)and an observation group(n=49).The control group received routine swallowing training combined with neuromuscular electrical stimulation(NMES)therapy.The observation group received routine swallowing training combined with EMGBF therapy.The grading,clinical ef-ficacy,surface electromyography(sEMG)test results,standardized swallowing assessment(SSA)and swallowing related Quality of Life Scale(SWAL-QOL)were compared before and after treatment between the two groups.Results Compared with before treatment,the drinking water test of the two groups were significantly improved,and the improvement effect was more significant in the observation group(P<0.05).The average sEMG amplitude was significantly increased and the swallowing time was shortened in both groups,and the change was more significant in the observation group(P<0.05).The SSA score of the observation group was lower than that of the control group,and the SWAL-QOL score of the observation group was higher than that of the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).Conclusions EMGBF is more effective than NMES in the treatment of patients with dysphagia after acute hemorrhagic CVA.It can effectively improve the swallowing function and the quality of life.