电生理疗法联合吞咽训练治疗卒中后吞咽障碍患者的疗效

Effects of electrophysiological therapy combined with swallowing training on patients with dysphagia after stroke

目的探究电生理疗法联合吞咽训练改善卒中后吞咽障碍患者的效果。方法收集2022年6月至2023年6月就诊于龙岩人民医院的110例卒中后吞咽障碍患者,按照抽签法分为对照组和观察组,每组55例。对照组予以吞咽训练,观察组予以电生理疗法联合吞咽训练。治疗前后开展透视吞咽检查(VFSS)评价患者吞咽功能,采用匹茨堡睡眠质量指数量表(PSQI)评估患者睡眠情况,使用吞咽患者生活质量量表(SWAL-QOL)评价患者生活质量。比较患者治疗前后VFSS、PSQI、SWAL-QOL评分,及表面肌电信号(sEMG)和临床疗效。结果与治疗前比较,治疗后两组患者各期吞咽功能VFSS评分及VFSS总分均升高,且观察组高于对照组,差异具有统计学意义(P<0.05)。与治疗前比较,治疗后两组患者SWAL-QOL和PSQI量表评分均降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者sEMG最大波幅均升高,且观察组高于对照组(P<0.05);治疗后两组患者吞咽时程均降低,且观察组低于对照组(P<0.05)。观察组临床总有效率高于对照组(94.5%比76.4%,P=0.030)。结论电生理疗法联合吞咽训练予以卒中后吞咽障碍患者,有助于改善患者吞咽障碍与睡眠质量,提高生活质量和表面肌电信号波幅。

Objective To explore the effects of electrophysiological therapy combined with swallowing training on patients with dysphagia after stroke.Methods One hundred and ten patients with dysphagia after stroke in Longyan People's Hospital from June 2022 to June 2023 were divided into control group and observation group by lottery,with 55 cases in each group.Patients in the control group were given swallowing training,electrophysiological therapy combined with swallowing training in the observation group.Before and after treatment,video-fluoroscopic swallowing study(VFSS)was carried out to evaluate the swallowing function,Pittsburgh sleep quality index scale(PSQI)was used to evaluate the sleeping condition,and SWAL-QOL was used to evaluate the quality of life of patients.The scores of VFSS,PSQI,SWAL-QOL,surface electromyography(sEMG)and clinical efficacy were compared.Results Compared with before the treatment,the VFSS score of the two groups increased after the treatment,and was higher in the observation group compared with the control group,with statistical significance(P<0.05).Compared with before the treatment,the scores of SWAL-QOL and PSQI in the two groups decreased after the treatment,more lower in the observation group,with statistical significance(P<0.05).After the treatment,the maximum amplitude of sEMG was increased in both groups,and more higher in the observation group(P<0.05).After the treatment,the swallowing duration of both groups was decreased,and more lower in the observation group(P<0.05).The total effective rate in the observation group was higher than that in the control group(94.5%vs.76.4%,P=0.030).Conclusion Electrophysiological therapy combined with swallowing training for patients with dysphagia after stroke is helpful to improve their dysphagia and sleep quality,improve their quality of life and increase the amplitude of surface electromyography signals.