张云，马明，蔡倩，杨玺，孙悦，刘进，徐亮.外周磁刺激与神经肌肉电刺激治疗脑卒中后咽期吞咽障碍的疗效对比[J].中华物理医学与康复杂志,2018,40(6):424-427
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| 外周磁刺激与神经肌肉电刺激治疗脑卒中后咽期吞咽障碍的疗效对比 |
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| DOI： |
| 中文关键词: 外周磁刺激 神经肌肉电刺激 咽期吞咽障碍 脑卒中 |
| 英文关键词: Peripheral magnetic stimulation Neuromuscular electrical stimulation Pharyngeal dysphagia Stroke |
| 基金项目:江苏省卫生和计划生育委员会科研课题资助项目（MS201509） |
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| 中文摘要: |
| 目的 观察对比外周磁刺激（PMS）与神经肌肉电刺激（NMES）治疗脑卒中后咽期吞咽障碍的疗效。 方法 采用随机数字表法将60例符合筛选标准的脑卒中咽期吞咽障碍患者分成对照组、电刺激组及磁刺激组，每组20例。3组患者均给予常规吞咽功能训练，电刺激组在此基础上辅以神经肌肉电刺激，磁刺激组则辅以外周磁刺激，上述干预均每天治疗2次，每周治疗6d。于治疗前、治疗4周后分别采用标准吞咽量表（SSA）、功能性经口摄食量表（FOIS）及包括渗透-误吸量表评分（PAS)和视频吞咽障碍分级（VDS)在内的视频透视吞咽检查（VFSS）对3组患者治疗效果进行评价。 结果 治疗4周后发现3组患者SSA评分、渗透-误吸量表（PAS)评分、视频吞咽障碍分级（VDS)评分及FOIS评分均较治疗前明显改善（P<0.05）；进一步分析发现，电刺激组、磁刺激组SSA评分［分别为(30.6±3.2)分、(24.1±2.8)分］、VDS评分［分别为(24.4±5.6)分、(18.2±8.2)分］、PAS评分［分别为(3.25±1.12)分、(2.56±0.66)分］及FOIS评分［分别为(4.31±0.97)分、(4.94±0.81)分］改善幅度均显著优于对照组（P<0.05），并且磁刺激组上述指标的改善幅度亦显著优于电刺激组，组间差异具有统计学意义（P<0.05）。 结论 外周磁刺激可明显改善脑卒中后咽期吞咽障碍，其治疗效果明显优于神经肌肉电刺激。 |
| 英文摘要: |
| Objective To compare the curative effect of peripheral magnetic stimulation (PMS) with that of neuromuscular electrical stimulation therapy (NMES) for stroke survivors with pharyngeal dysphagia. Methods Sixty stroke survivors were randomly divided into a PMS group, an NMES group and a control group, each of 20. In addition to routine swallowing training, the patients in the PMS and NMES groups were provided with PMS and NMES of the suprahyoid muscles respectively twice a day, six days a week for 4 weeks. Before and after the treatment, all were evaluated using a standardized swallowing assessment (SSA), the functional oral intake scale (FOIS) and videofluoroscopic swallowing study (VFSS). Results Before the intervention there was no significant difference among the three groups in terms of any of the measurements. After the treatment, significant improvement was observed in all of the values in all three groups compared to before the treatment. The average SSA, FOIS and VFSS results of the PMS and NMES groups as reflected by scores on the penetration-aspiration scale and a videofluoroscopic dysphagia scale had improved significantly more than in the control group. And the PMS group had improved significantly more than the NMES group. Conclusion Peripheral magnetic stimulation is more effective than NMES therapy in treating stroke patients with pharyngeal dysphagia. |
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