双侧重复经颅磁刺激联合常规康复训练在脑卒中后吞咽障碍患者治疗中的临床应用

Clinical Application of Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Routine Rehabilitation Training in the Treatment of Patients with Dysphagia after Stroke

目的:探究双侧重复经颅磁刺激(rTMS)联合常规康复训练在脑卒中后吞咽障碍患者治疗中的临床应用效果。方法:选取2021年1月—2024年4月沂水县人民医院收治的120例脑卒中后吞咽障碍患者为研究对象,采用随机数表法将其分为对照组和探究组,每组60例。两组均接受常规康复训练,对照组采用单侧rTMS,探究组采用双侧rTMS。对比两组神经生物学指标、吞咽功能、经口摄食能力及吞咽障碍预后水平。结果:治疗后,探究组神经肽Y、扣针蛋白-5、神经元特异性烯醇化酶、视锥蛋白样蛋白-1均低于对照组,差异均有统计学意义(P<0.05)。治疗后,探究组洼田饮水试验、吞咽障碍的结局和严重度量表、功能性经口摄食量表评级均优于对照组,差异均有统计学意义(P<0.05)。结论:双侧rTMS联合常规康复训练应用于脑卒中后吞咽障碍患者中,能够有效优化患者的神经生物学指标,改善其吞咽功能、经口进食能力及吞咽障碍预后水平。

Objective:To explore the clinical effect of bilateral repetitive transcranial magnetic stimulation(rTMS)combined with routine rehabilitation training in the treatment of patients with dysphagia after stroke.Methods:A total of 120 patients with dysphagia after stroke treated in Yishui County People’s Hospital from January 2021 to April 2024 were selected as the study objects,and were divided into a control group and an inquiry group by random number table method,with 60 cases in each group.Both groups received routine rehabilitation training,the control group received unilateral rTMS,the group received bilateral rTMS.Neurobiological indexes,swallowing function,oral feeding ability and prognosis of dysphagia were compared between the two groups.Results:After treatment,neuropeptide Y,fibulin-5,neuron specific enolase and visinin like protein-1 in the inquiry group were lower than those in the control group,with statistical significance(P<0.05).After treatment,the levels of Water Swallow Test,Dysphagia Outcome Severity Scale and Functional Oral Intake Scale in the inquiry group were better than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Bilateral rTMS combined with routine rehabilitation training can effectively optimize the neurobiological indexes of patients with dysphagia after stroke,improve their swallowing function,oral feeding ability and prognosis of dysphagia.