神经肌肉电刺激与吞咽训练对脑出血吞咽障碍患者的作用

Effects of neuromuscular electrical stimulation combined with swallowing training in patients with dysphagia after cerebral hemorrhage

目的研究神经肌肉电刺激(neuromuscular electrical stimulation,NMES)、吞咽训练对脑出血吞咽障碍患者吞咽功能、吞咽障碍特异性生活质量量表(swallowing quality of life,SWAL-QOL)、营养状况的影响。方法选择80例脑出血吞咽障碍患者,依据随机数字表法将80例脑出血吞咽障碍患者分为联合组(n=40)、对照组(n=40)。对照组行吞咽训练,联合组行NMES联合吞咽训练。治疗前后,观察两组吞咽功能、生活质量、血清甘油三酯(TG)、前白蛋白(PA)及白蛋白(ALB)等营养状况指标及不良反应。结果治疗后,标准吞咽功能评定量表(standardized swallowing assessment,SSA)评分联合组低于对照组,Gugging吞咽功能评估量表(gugging swallowing screen,GUS)评分及生活质量SWAL-QOL评分联合组均高于对照组(P<0.05)。治疗后,血清TG、PA及ALB水平,联合组均高于对照组(P<0.05)。联合组总有效率大于对照组(P<0.05)。两组均无显著不良反应。结论NMES、吞咽训练可增强脑出血吞咽障碍患者吞咽功能,提高SWAL-QOL评分,改善营养状况,且安全性较高。

Objective To investigate the effects of neuromuscular electrical stimulation(NMES)and swallowing training on swallowing function,Swallowing Quality of Life(SWAL-QOL),and nutritional status in patients with dysphagia after cerebral hemorrhage.Methods A total of 80 patients with dysphagia after cerebral hemorrhage were selected and randomly divided into a combined group(n=40)and a control group(n=40)using a random number table.The control group received swallowing training alone,while the combined group received NMES combined with swallowing training.Before and after treatment,swallowing function,quality of life,nutritional status indicators including serum triglycerides(TG),prealbumin(PA),and albumin(ALB),as well as adverse reactions,were observed and compared between the two groups.Results After treatment,the standardized swallowing assessment(SSA)scores were lower in the combined group than in the control group,while the Gugging swallowing screen(GUS)scores and SWAL-QOL scores were higher in the combined group(P<0.05).Additionally,serum levels of TG,PA,and ALB were significantly higher in the combined group compared to the control group(P<0.05).The total effective rate was also higher in the combined group than in the control group(P<0.05).No significant adverse reactions were observed in either group.Conclusions NMES combined with swallowing training can enhance swallowing function,improve SWAL-QOL scores,and optimize nutritional status in patients with dysphagia after cerebral hemorrhage,with high safety.