摘要
目的:观察小脑重复经颅磁刺激(rTMS)联合吞咽康复训练对脑卒中后吞咽障碍患者脑干听觉诱发电位、吞咽功能和血清神经损伤指标的影响。方法:纳入我院于2019年10月-2021年3月期间收治的60例脑卒中后吞咽障碍患者。按照随机数字表法分为对照组(给予吞咽康复训练,30例)和观察组(给予小脑rTMS联合吞咽康复训练,30例),均治疗3周。观察两组治疗3周后的临床总有效率,对比两组治疗前、治疗3周后的吞咽功能、脑干听觉诱发电位和血清神经损伤指标。结果:观察组的临床总有效率高于对照组(P<0.05)。观察组治疗3周后改良曼恩吞咽能力评估量表(MMASA)评分升高,且高于对照组(P<0.05)。观察组治疗3周后波潜伏期(Ⅰ、Ⅲ、Ⅳ)、波峰间潜伏期(Ⅰ~Ⅲ,Ⅲ~Ⅳ,Ⅰ~Ⅳ)降低,且低于对照组(P<0.05)。观察组治疗3周后血清视锥蛋白样蛋白1(VILIP-1)、神经肽Y(NPY)、神经元特异性烯醇化酶(NSE)、扣针蛋白5(Fibulin-5)水平降低,且低于对照组(P<0.05)。结论:小脑rTMS联合吞咽康复训练可有效改善脑卒中后吞咽障碍患者的吞咽功能,减轻神经损伤,缩短脑干听觉诱发电位的潜伏期。
Objective:To observe the effect of cerebellar repetitive transcranial magnetic stimulation(rTMS)combined with swallowing rehabilitation training on brainstem auditory evoked potential,swallowing function and serum nerve injury indexes in patients with dysphagia after stroke.Methods:60 patients with dysphagia after stroke who were admitted to our hospital from October 2019 to March 2021 were included.According to the random number table method,they were divided into the control group(swallowing rehabilitation training,30 cases)and the observation group(rTMS combined with swallowing rehabilitation training,30 cases),all of which were treated for 3 weeks.The clinical total effective rate of the two groups at 3 weeks after treatment was observed,and the swallowing function,brainstem auditory evoked potential and serum nerve injury indexes of the two groups before and 3 weeks after treatment were compared.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).3 weeks after treatment,the score of modified Mann swallowing ability assessment scale(MMASA)of the observation group was increased,and it was higher than that in the control group(P<0.05).3 weeks after treatment,the wave latency(Ⅰ,Ⅲ,Ⅳ)and inter peak latency(Ⅰ~Ⅲ,Ⅲ~Ⅳ,Ⅰ~Ⅳ)of the observation group were decreased,and they were lower than those of the control group(P<0.05).3 weeks after treat-ment,the levels of serum cone-like protein 1(VILIP-1),neuropeptide Y(NPY),neuron-specific enolase(NSE),Fibulin-5(Fibulin-5)of the observation group were decreased,and they were lower than those of the control group(P<0.05).Conclusion:Cerebellar rTMS combined with swallowing rehabilitation training can can effectively promote the improvement of dysphagia after stroke,reduce nerve injury,and shorten the latency of brainstem auditory evoked potential.
作者
黎继华
孙嘉惠
杜东
张盛全
范建中
LI Ji-hua;SUN Jia-hui;DU Dong;ZHANG Sheng-quan;FAN Jian-zhong(Department of Rehabilitation Physiotherapy,Nan fang Hospital of Southern Medical University,Guangzhou,Guangdong,510515,China)
出处
《现代生物医学进展》
CAS
2022年第6期1052-1055,1023,共5页
Progress in Modern Biomedicine
基金
广东省自然科学基金项目(2016A030313523)。
关键词
小脑重复经颅磁刺激
康复训练
脑卒中后吞咽障碍
吞咽功能
脑干听觉诱发电位
神经损伤
Cerebellar repetitive transcranial magnetic stimulation
Rehabilitation training
Dysphagia after stroke
Swallowing function
Brainstem auditory evoked potential
Nerve injury
