神经肌肉电刺激促进颅脑损伤后吞咽功能恢复

Neuromuscularelectrical stimulation promotes swallowing function recovery aftertraumatic brain injury

目的探讨神经肌肉电刺激(NMES)对颅脑损伤后吞咽功能障碍的治疗效果。方法2021年6月至2022年5月前瞻性收集60例颅脑损伤后伴发吞咽功能障碍病人,随机分为对照组(n=30)和NMES组(n=30)。对照组进行吞咽训练,包括进食训练、吞咽训练、屏气训练及发音训练等;NMES组在对照组治疗的基础上增加神经肌肉电刺激;疗程均为4周。运用洼田饮水试验(KDWT)分级、电视透视吞咽功能检查结合渗透-误吸量表(PAS)评分评估吞咽功能。结果治疗前,两组KDWT分级和PAS评分均为统计学差异(P>0.05)。治疗后4周,两组KDWT分级明显降低(P<0.05),PAS评分明显增高(P<0.05);而且,NMES组KDWT分级和PAS评分均明显优于对照组(P<0.05)。结论颅脑损伤后伴发吞咽功能障碍,在积极吞咽训练基础上进行NMES治疗显著促进吞咽功能恢复。

Objective To investigate the therapeutic effect of neuromusculaRelectrical stimulation(NMES)on dysphagia after traumatic brain injury(TBI).Methods Prospective data were collected from 60 patients with dysphagia afteRTBI from June 2021 to May 2022,and they were randomly divided into control group(n=30)and NMES group(n=30).The patients in the control group received swallowing training,including eating training,swallowing training,breath-holding training,and speech training.The patients in the NMES group received NMES based on the treatment in the control group.The treatment course was 4 weeks in both groups.The Kubota drinking wateRtest(KDWT)score and the penetration-aspiration scale(PAS)score based on the videofluoroscopic swallowing study were used to assess the swallowing function.Results Before treatment,the KDWT score and the PAS score in the two groups were not statistically significant(P>0.05).AfteR4 weeks of treatment,the KDWT score was significantly decreased and the PAS score was significantly increased in both groups(P<0.05).Moreover,the KDWT score and the PAS score in the NMES group were significantly betteRthan those in the control group(P<0.05).Conclusion FoRpatients with dysphagia afteRTBI,NMES treatment based on active swallowing training significantly promotes recovery of swallowing function.