摘要
目的 探究低频脉冲治疗仪联合摄食-吞咽训练治疗脑卒中后吞咽障碍患者的临床疗效。方法 回顾性选择2022年1月至2024年1月武汉科技大学附属普仁医院收治的脑卒中后吞咽障碍患者122例,根据治疗方法不同分为对照组60例(常规治疗基础上予以摄食-吞咽训练)和联合组62例(对照组基础上联合低频脉冲治疗仪治疗)。观察2组治疗前后吞咽造影检查(videofluoroscopic swallowing study, VFSS)评分、标准吞咽功能评价量表(standard swallowing assessment, SSA)评分、舌骨运动位移(舌骨前移、上移)、椎基底动脉血流情况[搏动指数(pulsatility index, PI)、平均血流速度(mean blood flow velocity, Vm)、收缩期血流速度(systolic blood flow velocity, Vs)]、血清神经因子[神经生长因子(nerve growth factor, NGF)、脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)]、生活质量(吞咽障碍特异性生活质量量表)变化和治疗期间并发症发生情况。结果 2组治疗后VFSS评分、生活质量和吞咽症状评分、舌骨前移和舌骨上移距离、椎基底动脉Vm和Vs、血清NGF、BDNF水平较治疗前明显升高,SSA评分、椎基底动脉PI较治疗前明显降低,差异有统计学意义(P<0.05)。与对照组比较,联合组治疗后VFSS评分、生活质量和吞咽症状评分、舌骨前移和舌骨上移距离、椎基底动脉Vm和Vs、血清NGF、BDNF水平明显升高,SSA评分、椎基底动脉PI明显降低,差异有统计学意义(P<0.05,P<0.01)。联合组与对照组总并发症发生率比较,差异无统计学意义(4.8%vs 10.0%,P>0.05)。结论 低频脉冲治疗仪联合摄食-吞咽训练联合治疗脑卒中吞咽障碍可有效促进吞咽功能的恢复,增加舌骨活动度,改善椎基底动脉血流和神经营养情况,提高生活质量,且相关并发症少。
Objective To explore the clinical efficacy of low-frequency pulse therapy combined with ingestion-swallowing training in the treatment of patients with post-stroke dysphagia.Methods A retrospective study was conducted on 122 patients with post-stroke dysphagia admitted in our hospital from January 2022 to January 2024.According to different interventions,they were divid-ed into a control group(ingestion-swallowing training on the basis of conventional treatment,60 cases)and a combined treatment group(low-frequency pulse therapy and the treatments in the control group,62 cases).Before and after treatment,VFSS and standard swallowing assessment(SSA)were performed,hyoid bone movement displacement(hyoid bone forward and upward)and vertebrobasilar artery blood flow indicators[pulsatility index(PI),mean blood flow velocity(Vm),systolic blood flow velocity(Vs)]were observed,and serum levels of nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)were detected in all the patients.The chan-ges in quality of life(swallow quality of life questionnaire)and occurrence of complications during treatment were observed in the two groups.Results In both groups after treatment,the VFSS score,quality of life score and swallowing symptom score,hyoid bone forward and upward dis-tances,vertebrobasilar artery Vm and Vs,and serum NGF and BDNF levels were all risen signifi-cantly while the SSA score and vertebrobasilar artery PI were obviously declined when com pared with the levels before treatment(P<0.05).After treatment,the combined treatment group had more remarkably improved VFSS score,quality of life score,swallowing symptom score,hyoid bone forward and upward distances,vertebrobasilar Vm and Vs,and serum NGF and BDNF levels,and more notably declined SSA score and vertebrobasilar PI than the control group(P<0.05,P<0.01).No statistical difference was seen in the total incidence of complications between the combined treatment group and control group(4.8%vs 10.0%,P>0.05).Conclusion Com-bined low-frequency pulse therapy and ingestion-swallowing training can effectively promote the recovery of swallowing function,increase the activity of hyoid bone,promote the vertebrobasilar artery blood flow and neurotrophic conditions,and thus improve the quality of life in patients with post-stroke dysphagia,with less complications.
作者
张鑫
张仲锦
程伟
刘慧晴
周山虎
Zhang Xin;Zhang Zhongjin;Cheng Wei;Liu Huiqing;Zhou Shanhu(De partment of Rehabilitation Medicine,Puren Hospital Affiliated to W uhan University of Science and Technology,Wuhan 430080,Hubei Province,China)
出处
《中华老年心脑血管病杂志》
北大核心
2025年第6期712-716,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
湖北省医学科研项目(2021W639)。
关键词
卒中
吞咽障碍
临床研究
生活质量
stroke
deglutition disorders
clinical study
quality of life
