王伟,刘亚群,杨娜.导管球囊扩张术联合重复经颅磁刺激治疗脑卒中后环咽肌失弛缓致吞咽功能障碍的临床观察[J].中华物理医学与康复杂志,2021,43(8):717-720
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| 导管球囊扩张术联合重复经颅磁刺激治疗脑卒中后环咽肌失弛缓致吞咽功能障碍的临床观察 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.08.011 |
| 中文关键词: 导管球囊扩张技术 重复经颅磁刺激 吞咽功能障碍 脑卒中 |
| 英文关键词: Balloon dilation therapy: Transcranial magnetic stimulation: Dysphagia: Stroke |
| 基金项目:全军保健专项课题(20BJZ08) |
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| 中文摘要: |
| 目的 观察导管球囊扩张技术联合经颅磁刺激治疗脑卒中后环咽肌失弛缓致吞咽功能障碍患者的临床疗效。 方法 选取脑卒中后环咽肌失弛缓所致吞咽功能障碍患者90例，按随机数字表法分为球囊扩张组、重复经颅磁刺激（rTMS）组和联合治疗组，每组30例。球囊扩张组给予导管球囊扩张技术治疗，rTMS组给予重复经颅磁刺激治疗，联合治疗组给予导管球囊扩张技术联合重复经颅磁刺激治疗，治疗周期为4周。于治疗前和治疗4周后（治疗后）采用洼田饮水试验评分和标准吞咽功能评分（SSA）评估3组患者的吞咽功能，并于治疗后采用临床疗效评定评估3组患者的临床疗效。 结果 治疗后，3组患者洼田饮水试验加权评分和SSA评分较组内治疗前均显著降低，差异均有统计学意义（P<0.05），且联合治疗组的洼田饮水试验加权评分和SSA评分显著优于球囊扩张组和rTMS组，差异均有统计学意义（P<0.05）。治疗后，联合治疗组总有效率为96.7%，高于球囊扩张组的70.0%（χ2=7.68,P<0.01）和rTMS组的63.3%（χ2=10.42, P<0.01）。 结论 导管球囊扩张技术联合rTMS可显著改善脑卒中后环咽肌失弛缓致吞咽功能障碍患者的吞咽功能。 |
| 英文摘要: |
| Objective To observe the clinical efficacy of combining catheter balloon dilation therapy with transcranial magnetic stimulation in the treatment of stroke survivors with swallowing dysfunction caused by cyclopharyngeal muscle dysfunction. Methods Ninety stroke survivors with swallowing dysfunction caused by cyclopharyngeal muscle dysfunction were randomly divided into a balloon dilation group, an rTMS group and a combination treatment group, each of 30. The groups received balloon dilation therapy, repetitive transcranial magnetic stimulation or both respectively for 4 weeks. A water swallowing test and the Standardized Swallowing Assessment were administered before and after the treatment. Results After the treatment there was a significant decrease in the average scores of all three groups on both tests, but the improvement in the combination treatment group was significantly greater than in the other two groups. The total effectiveness rate of the combination treatment was 96.7%, significantly higher than the 70.0% of the balloon dilation treatment and the 63.3% with magnetic stimulation alone. Conclusion Combining catheter balloon dilation therapy with repetitive transcranial magnetic stimulation can significantly improve the swallowing function of stroke survivors caused by cyclopharyngeal muscle dysfunction. |
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