Vitalstim吞咽治疗仪及舌压抗阻反馈训练对脑梗死后吞咽障碍患者舌骨运动度及吞咽功能的影响

Effects of Vitalstim swallowing therapeutic instrument and tongue pressure resistance feedback training on hyoid motion degreeand swallowing function in patients with dysphagia after cerebral infarction

目的探讨Vitalstim吞咽治疗仪及舌压抗阻反馈训练对脑梗死后吞咽障碍患者舌骨运动度及吞咽功能的影响。方法选取2021年8月至2022年8月盐城市第三人民医院收治的脑梗死后吞咽障碍患者81例,随机分为3组:对照A组、对照B组、联合组,每组各27例。对照A组采取Vitalstim吞咽治疗仪,对照B组采取舌压抗阻反馈练习,联合组采取Vitalstim吞咽治疗仪及舌压抗阻反馈练习。统计3组干预效果、干预前后舌骨运动度、吞咽功能及生活质量、不良事件发生率。结果(1)联合组总有效率高于对照A组、对照B组(P均<0.05),对照A组、对照B组治疗总有效率差异无统计学意义(P>0.05)。(2)干预后3组舌骨上、下移动度较干预前增大,且联合组舌骨上、下移动度大于对照A组、对照B组(P均<0.05),干预后对照A组、对照B组舌骨上、下移动度间差异无统计学意义(P均>0.05)。(3)干预后3组标准吞咽功能评定表(SSA)分值较干预前下降,改良曼恩吞咽能力评估量表(MMASA)分值、吞咽障碍的结局与严重度量表(DOSS)分值较干预前增高,且联合组SSA分值较对照A组、对照B组低,MMASA及DOSS分值较对照A组、对照B组高(P均<0.05),干预后对照A组、对照B组的SSA、MMASA、DOSS分值差异无统计学意义(P均>0.05)。(4)干预后3组吞咽障碍特异性生活质量表(SWAL-QOL)分值较干预前增高,且联合组SWAL-QOL分值高于对照A组、对照B组(P均<0.05),干预后对照A组、对照B组SWAL-QOL分值差异无统计学意义(P>0.05)。(5)联合组不良事件发生率低于对照A组、对照B组(P均<0.05),对照A组、对照B组不良事件发生率差异无统计学意义(P>0.05)。结论联合Vitalstim吞咽治疗仪及舌压抗阻反馈训练对脑梗死后吞咽障碍患者实施干预效果显著,有利于减少不良事件的发生。

Objective To investigate the effect of Vitalstim swallowing therapeutic instrument and tongue pressure resistance feedback training on hyoid motion degreeand swallowing function in patients with dysphagia after cerebral infarction.Methods A total of 81 patients with dysphagia after cerebral infarction admitted to the hospital from August 2021 to August 2022 were randomly divided into 3 groups:control group A,control group B and combination group,with 27 cases in each group.The control group A was treated with Vitalstim swallowing therapeutic apparatus,the control group B was treated with tongue pressure resistance feedback exercise,and the combined group was treated with Vitalstim swallowing therapeutic apparatus and tongue pressure resistance feedback exercise.The intervention effect,hyoid motion,swallowing function,quality of lifeand the incidence of adverse events of the three groups were statistically analyzed.Results(1)The total effective rate of combination group was higher than that of control group A and control group B(P<0.05),but there was no significant difference between control group A and control group B(P>0.05).(2)The superior and inferior hyoid movement of the three groups were increased after the intervention compared with that before the intervention,and the superior and inferior hyoid movement of the combination group was greater than that of control group A and control group B(P<0.05),and there was no significant difference between the superior and inferior hyoid movement of control group A and control group B after the intervention(P>0.05).(3)After the intervention,the standard swallowing function rating scale(SSA)of the three groupswere decreased compared with that before the intervention,and the scores of modified Mann Swallowing Ability Assessment Scale(MMASA),swallowing disorder outcome and severity scale(DOSS)wasincreased compared with that before the intervention,and SSA of the combination group was lower than that of control group A and control group B.MMASA and DOSS was higher than those in control group A and control group B(P<0.05),but there was no significant difference in SSA,MMASA and DOSS scores between control group A and control group B after the intervention(P>0.05).(4)After the intervention,the SWAL-QOL score of dysphagia-specific Quality of Life(SWAL-QOL)in the three groups was higher than that before the intervention,and the SWAL-QOL score in the combination group was higher than that in control group A and control group B(P<0.05),but there was no statistical significance between control group A and control group B after the intervention(P>0.05).(5)The incidence of adverse events in combination group were lower than that in control group A and control group B(P<0.05),but there was no significant difference between control group A and control group B(P>0.05).Conclusion The combination of Vitalstim swallowing therapeutic instrument and tongue pressure resistance feedback training has a significant intervention effect on patients with dysphagia after cerebral infarction,which is conducive to reducing adverse events.