刘增进,曹荣智,李和平,等.经颅直流电刺激联合经口至食管间歇管饲治疗脑梗死后吞咽障碍的疗效观察[J].中华物理医学与康复杂志,2025,47(9):822-826
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| 经颅直流电刺激联合经口至食管间歇管饲治疗脑梗死后吞咽障碍的疗效观察 |
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| DOI：10.3760/cma.j.cn421666-20240906-00720 |
| 中文关键词: 脑梗死 吞咽障碍 经颅直流电刺激 间歇经口至食管管饲 |
| 英文关键词: Stroke Dysphagia Transcranial direct current stimulation Tube feeding |
| 基金项目:国家卫生健康委脑血管病防治重点实验室资助项目（2020-PT310-01） |
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| 中文摘要: |
| 目的 观察经颅直流电刺激（tDCS）联合间歇经口至食管管饲(IOE)治疗脑梗死后吞咽障碍的疗效。 方法 采用随机数字表法将84例脑梗死后吞咽障碍患者分为观察组及对照组，每组42例。所有患者均给予常规治疗及吞咽康复训练，且均使用IOE方式进行肠内营养支持；在此基础上观察组患者辅以tDCS治疗。于治疗前、治疗14 d后分别使用渗漏误吸量表(PAS)、功能性经口摄食量表(FOIS)、吞咽障碍指数(DHI)及9条目患者健康问卷（PHQ-9）评估2组患者吞咽功能、生活质量及抑郁情绪改善情况。 结果 治疗后2组患者PAS、FOIS评级、DHI、PHQ-9评分及抑郁阳性率均较治疗前明显改善（P＜0.05），并且治疗后观察组PAS、FOIS评级、DHI指数［(51.25±6.78) vs (44.78±5.75)］、PHQ-9评分［(4.17±1.15) 分vs (6.01±1.93) 分］及抑郁阳性率(14.29% vs 42.86%)亦显著优于同期对照组水平（P＜0.05）。 结论 tDCS联合IOE管饲能进一步改善脑梗死患者吞咽功能、抑郁情绪及生活质量，该治疗模式值得临床推广、应用。 |
| 英文摘要: |
| Objective To observe any therapeutic effect of transcranial direct current stimulation (tDCS) combined with intermittent oroesophageal tube feeding (IOE) on dysphagia among ischemic stroke survivors. Methods Eighty-four ischemic stroke survivors with dysphagia were randomized into an observation group and a control group, each of 42. In addition to conventional rehabilitation, swallowing training and IOE, the observation group received tDCS while the control group received sham stimulation. Before and after 14 days of this treatment, both groups′ swallowing, life quality and depression were evaluated using the Penetration Aspiration Scale (PAS), the Functional Oral Intake Scale (FOIS), the Dysphagia Handicap Index (DHI), and a 9-item patient health questionnaire (PHQ-9). Results There were no significant differences between the two groups before the experiment in terms of their general data, their average PAS, FOIS, DHI or PHQ-9 scores, or the incidence of depression. After the treatment, significant improvement was observed in the above indicators among both groups, but with significantly better average PAS, FOIS, DHI ［(51.25±6.78) vs. (44.78±5.75)］ and PHQ-9 ［(4.17±1.15) vs. (6.01±1.93)］ scores and less depression (14.29% vs. 42.86%) in the observation group compared with the control group. Conclusions Combining tDCS with IOE better improves swallowing function, depression, and life quality after an ischemic stroke. |
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