子午流注低频电疗治疗脑梗死后吞咽功能障碍临床研究

Clinical Study on Low-Frequency Therapeutic Instrument of the Ebb and Flow of Midnight and Midday for Swallowing Disorders After Cerebral Infarction

目的:观察子午流注低频电疗治疗脑梗死后吞咽功能障碍的效果。方法:将92例脑梗死后吞咽功能障碍患者分为2组各46例,2组均予脑梗死三级预防治疗和吞咽功能训练,观察组加用子午流注低频电疗,2组疗程均为21 d。比较2组临床疗效,治疗前后进行洼田饮水试验(WST)、视频透视吞咽功能检查(VFSS)和检测表面肌电图(sEMG),评定标准吞咽功能评估量表(SSA)评分、吞咽障碍特异性生活质量量表(SWAL-QOL)评分。结果:治疗后,观察组总有效率89.1%,对照组总有效率71.7%,2组比较,差异有统计学意义(P<0.05)。2组WST分级结果均优于治疗前(P<0.05),观察组WST分级结果优于对照组(P<0.05)。2组SSA评分与同组治疗前比较均降低(P<0.05),VFSS、SWAL-QOL评分均较治疗前升高(P<0.05)。观察组SSA评分低于对照组(P<0.05),VFSS、SWAL-QOL评分均高于对照组(P<0.05)。2组sEMG最大波幅值与同组治疗前比较均升高(P<0.05),吞咽时间均较治疗前缩短(P<0.05)。观察组sEMG最大波幅值高于对照组(P<0.05),吞咽时间较对照组缩短(P<0.05)。结论:在脑梗死三级预防治疗和吞咽功能训练的基础上加用子午流注低频电疗治疗脑梗死后吞咽功能障碍可以提高疗效,有效改善患者的吞咽功能,提高生活质量。

Objective:To observe the effect of low-frequency therapeutic instrument of the ebb and flow of midnight and midday for swallowing disorders after cerebral infarction.Methods:A total of 92 cases of patients with swallowing disorders after cerebral infarction were divided into two groups,with 46 cases in each group.Both groups were treated with three-level prevention and treatment of cerebral infarction and swallowing function training,and the observation group was additionally treated with low-frequency therapeutic instrument of the ebb and flow of midnight and midday.Both groups were treated for 21 days.The clinical effects were compared between the two groups.The Water Swallow Test(WST),Videofluoroscopic Swallowing Study(VFSS)and surface electromyography(sEMG)were conducted before and after treatment.The scores of Standardized Swallowing Assessment(SSA)and Swallowing Quality-of-Life(SWAL-QOL)questionnaire were evaluated.Results:After treatment,the total clinical effective rate was 89.1%in the observation group and 71.7%in the control group,the difference being significant(P<0.05).The WST grading results in the two groups were better than those before treatment(P<0.05),and the WST grading result in the observation group was better than that in the control group(P<0.05).The SSA scores in the two groups were decreased when compared with those before treatment(P<0.05),the scores of VFSS and SWAL-QOL were increased when compared with those before treatment(P<0.05).The SSA score in the observation group was lower than that in the control group(P<0.05),and the scores of VFSS and SWAL-QOL were higher than those in the control group(P<0.05).The maximum wave amplitude of sEMG in the two groups were increased when compared with those before treatment(P<0.05),and the swallowing time were shortened when compared with those before treatment(P<0.05);the maximum wave amplitude of sEMG in the observation group was higher than that in the control group(P<0.05),and the swallowing time was shorter than that in the control group(P<0.05).Conclusion:Based on three-level prevention and treatment of cerebral infarction and swallowing function training,the additional application of low-frequency therapeutic instrument of the ebb and flow of midnight and midday for swallowing disorders after acute cerebral infarction can enhance curative effect,and effectively improve swallowing function and quality of life.