神经肌肉电刺激对卒中性吞咽障碍疗效的研究.docVIP

神经肌肉电刺激对卒中性吞咽障碍疗效的研究作者：晋丹丹 张 华宁夏回族自治区人民医院神经内科 银川 750021【摘 要】? 目的 探讨神经肌肉电刺激对卒中性吞咽障碍患者的疗效。方法 将200例吞咽功能评级5级及以下的脑卒中患者分为对照组67例和研究组133例，均给予常规药物治疗配合吞咽功能训练，研究组加用电刺激治疗仪。个疗程后进行吞咽评级比较。结果 研究组吞咽评级结果明显优于对照组，差异有统计学意义(P0.01加用神经肌肉电刺激治疗后，单侧大脑卒中组疗效优于双侧大脑卒中组缺血性脑卒中组疗效优于出血性脑卒中组。结论 神经肌肉电刺激疗法可明显提高卒中性吞咽障碍患者的吞咽功能，临床效果优于常规治疗。【关键词】神经肌肉电刺激脑卒中吞咽障碍Research of neuromuscular electrical stimulation on the effect of post-stroke disphasia and neuroplasticity Jin Dandan, Zhang Hua. Department of Neurology of People’s Hospital of Ningxia， Yinchuan 750021， China【Abstract】 Objective To observe the effect of neuromuscular electric stimulation on poststroke dysphasia. Methods Two hundred patients with disorder of swallowing function after stroke were randomly divided into control group with 67 cases and study group with 133 cases.All received pharmacotherapy and swallow function training study group received neuromuscular electrical stimulation based on the control group.Then their respective effects after 40 days treatment were compared. Results After treatment，evaluation of the results of water tests in study group was better than that of control group， the difference was significant (P0.01); For neuromuscular electrical stimulation therapy, efficacy of unilateral cortical stroke group was more better than double stroke cortex; efficacy of ischemic stroke group was better than hemorrhagic stroke group.Conclusion The neuromuscular electrical stimulation therapy can significantly improve stroke patients with dysphasia and swallowing function. Its efficacy is better than conventional training. 【Key words】 Neuromuscular electrical stimulationPost-stroke;Dysphasia 吞咽功能障碍在脑卒中患者中的发生率可高达30%～45%[1]，关注卒中后吞咽障碍的治疗对于改善脑卒中患者预后，减少吸入性肺炎，改善构音障碍，提高患者生活质量，降低致残率、病死率，减少治疗费用起到举足轻重的作用。我科对200例脑卒中后吞咽障碍的患者采用神经肌肉电刺激疗法(neuromuscular electric stimulation，NMES)配合常规吞咽功能训练，取得良好疗效，分析如下。1 资料与方法1.1 一般资料 选择我院神经内科200704～200909收治的卒中后吞咽障碍的患者200例。所有病例均符合全国脑血管疾病诊断标准，并经CT或MRI检查确诊为脑梗死和脑出血，经吞咽障碍评级≤5级。其中男119例，女81例年龄43～82岁，平均63.3岁。脑梗死142例，脑出