张耀文,谢纯青,万桂芳,等.神经肌肉电刺激对卒中后咽期吞咽启动延迟患者进食功能的即时效应观察[J].中华物理医学与康复杂志,2020,42(9):797-800
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| 神经肌肉电刺激对卒中后咽期吞咽启动延迟患者进食功能的即时效应观察 |
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| DOI：10.3760/cma.j.issn.0254-1424.2020.09.006 |
| 中文关键词: 神经肌肉电刺激 咽期吞咽启动延迟 脑卒中 |
| 英文关键词: Neuromuscular electrical stimulation Delayed swallowing Stroke |
| 基金项目:中山大学附属第三医院临床研究计划（NHJH201909）， 广州市科技计划项目（201604020153） |
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| 中文摘要: |
| 目的 观察神经肌肉电刺激（NMES）对脑卒中后咽期吞咽启动延迟患者的即时效应。 方法 选取42例脑卒中后咽期吞咽启动延迟患者，分别于NMES刺激前、刺激时进食3口稀流质食物，采用吞咽功能影像数字化采集与分析系统对患者进食过程进行记录、分析，分析项目包括咽期吞咽启动（IPS）、Rosenbek渗漏-误吸分级（PAS）、口腔运送时间（OTT）、喉前庭闭合时间（LCD）及咽通过时间（PTT）等。 结果 患者在NMES刺激时其IPS［2（1.0,3.0）级］、PAS［4（3.0,5.3）级］及OTT［（1712±595 ）ms］均较NMES刺激前明显改善（P<0.05），LCD［（575±46）ms］、PTT［（464±56）ms］均较刺激前无明显变化（P>0.05）。所有患者在NMES刺激过程中均未出现明显不良反应。 结论 NMES对卒中后咽期启动延迟患者口腔运送、吞咽启动功能及渗漏、误吸情况均有较好的即时改善作用，为卒中后患者开展早期治疗性进食提供了新的代偿手段。 |
| 英文摘要: |
| Objective To observe the immediate effect of neuromuscular electrical stimulation (NMES) on the initiation of swallowing among stroke survivors with dysphagia. Methods Forty-two patients with delayed swallowing initiation were asked to eat 3 boluses of a thin liquid before and during NMES stimulation. The process was recorded and analyzed using a digital data acquisition and analysis system, including the initiation of the pharyngeal swallow (IPS), oral transit time (OTT), larynx closure duration (LCD), and pharynx transit time (PTT). They were also evaluated using the Rosenbek penetration-aspiration scale (PAS). Results During NMES, significant improvement was observed in the average IPS, PAS and OTT results compared to before the intervention. There was, however, no significant difference in the average LCD or PTT. No obvious adverse reactions were observed during the stimulation. Conclusion NMES has an immediate effect on improving IPS, PAS and OTT, and can be used as a new compensatory early treatment for stroke survivors with dysphagia. |
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