手持感应电刺激对高血压脑出血患者吞咽功能的影响

Effect of handheld induction electrical stimulation on swallowing function in patients withhypertensive intracerebral hemorrhage

目的分析手持感应电刺激对高血压脑出血患者吞咽功能的影响。方法本研究为随机对照试验。选取2021年1月至2023年1月期间郑州市第九人民医院收治的高血压脑出血患者118例为研究对象,采用随机数字表法分为观察组和对照组,各59例。对照组中男性35例,女性24例,年龄(52.13±6.34)岁,发病至就诊时间(11.32±1.30)h;观察组中男性33例,女性26例,年龄(51.65±6.20)岁,发病至就诊时间(11.44±1.13)h。两组均在手术治疗后给予营养神经药物治疗,对照组联合常规康复训练,观察组在对照组基础上联合手持感应电刺激治疗,两组均治疗6周。比较两组患者治疗前3 d和完成治疗后3 d的舌肌压力、功能性经口摄食量表(FOIS)、Rosenbek渗漏/误吸量表评分,比较两组患者完成治疗后3 d内的临床疗效及治疗期间的并发症发生情况。采用t检验、χ^(2)检验。结果完成治疗后3 d,观察组的舌压平均值、舌压峰值均高于对照组[(49.85±7.65)kPa比(38.95±6.77)kPa、(56.98±5.69)kPa比(46.58±4.77)kPa],舌压持续时间长于对照组[(18.49±4.23)s比(13.56±4.11)s],差异均有统计学意义(t=2.549,P=0.016;t=2.292,P=0.036;t=3.376,P=0.001);观察组的FOIS评分高于对照组[(5.16±1.72)分比(3.54±1.45)分],Rosenbek渗漏/误吸量表评分低于对照组[(2.34±0.84)分比(3.61±0.92)分],临床总有效率高于对照组[91.53%(54/59)比64.40%(38/59)],并发症总发生率低于对照组[6.78%(4/59)比27.12%(16/59)],差异均有统计学意义(t=2.858,P=0.004;t=2.186,P=0.039;χ^(2)=7.355,P=0.019;χ^(2)=11.265,P=0.007)。结论手持感应电刺激治疗能够改善高血压脑出血患者的舌肌压力和吞咽功能,减少误吸相关并发症发生,改善临床疗效。

Objective To analyze the effect of handheld induction electrical stimulation on swallowing function in patients with hypertensive intracerebral hemorrhage.Methods This study was a randomized controlled trial.A total of 118 patients with hypertensive cerebral hemorrhage admitted to Zhengzhou Ninth People's Hospital from January 2021 to January 2023 were selected as the study subjects.They were divided into an observation group and a control group using the random number table method,with 59 cases in each group.In the control group,there were 35 males and 24 females,aged(52.13±6.34)years,and the time from onset to treatment was(11.32±1.30)h.In the observation group,there were 33 males and 26 females,aged(51.65±6.20)years,and the time from onset to treatment was(11.44±1.13)h.Both groups were treated with neurotrophic drugs after surgery,the control group was combined with routine rehabilitation training,and the observation group was combined with hand-held induction electrical stimulation.Both groups were treated for 6 weeks.The tongue muscle pressure,Functional Oral Intake Scale(FOIS)score,and Rosenbek Leakage/Aspiration Scale score were compared between the two groups 3 days before treatment and 3 days after treatment.The clinical efficacy within 3 days after treatment and complications during treatment were compared between the two groups.t test andχ^(2) test were used.Results Three days after treatment,the average and peak tongue pressure of the observation group were higher than those of the control group[(49.85±7.65)kPa vs.(38.95±6.77)kPa,(56.98±5.69)kPa vs.(46.58±4.77)kPa],and the duration of tongue pressure was longer than that of the control group[(18.49±4.23)s vs.(13.56±4.11)s],with statistically significant differences(t=2.549,P=0.016;t=2.292,P=0.036;t=3.376,P=0.001).The FOIS score of the observation group was higher than that of the control group[(5.16±1.72)points vs.(3.54±1.45)points],the Rosenbek Leakage/Aspiration Scale score was lower than that of the control group[(2.34±0.84)points vs.(3.61±0.92)points],the total clinical effective rate was higher than that of the control group[91.53%(54/59)vs.64.40%(38/59)],and the total incidence of complications was lower than that of the control group[6.78%(4/59)vs.27.12%(16/59)],with statistically significant differences(t=2.858,P=0.004;t=2.186,P=0.039;χ^(2)=7.355,P=0.019;χ^(2)=11.265,P=0.007).Conclusion Handheld induction electrical stimulation therapy can improve the tongue muscle pressure and swallowing function in patients with hypertensive intracerebral hemorrhage,reduce the aspiration related complications,and improve the clinical efficacy.