摘要
目的研究老年脑卒中合并吞咽障碍患者经高频重复经颅磁刺激(Repetitive Transcranial Magnetic Stimulation,rTMS)联合早期吞咽功能分级康复训练对神经及吞咽功能的临床应用价值。方法便利选取2021年1月-2023年1月泰州市第三人民医院收治的70例老年脑卒中合并吞咽障碍患者为研究对象,按随机数表法分为对照组(n=35,常规治疗)和观察组(n=35,rTMS联合早期吞咽功能分级康复训练)。比较两组治疗前后舌体移动度(舌骨上移距离、舌骨前移距离),神经功能[美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)]、吞咽功能[标准吞咽功能评分量表(Standard Swallowing Function Assessment Scale,SSA)]及生存质量[吞咽生存质量问卷(Swallowing Quality of Life,SWAL-QOL)]评分,观察两组不良反应发生情况。结果较治疗前,两组治疗后舌骨上移距离、舌骨前移距离及SWAL-QOL评分均升高,NIHSS评分、SSA评分均降低,且观察组较对照组更优,差异有统计学意义(P均<0.05)。观察组治疗总有效率(97.14%)高于对照组(82.86%),差异有统计学意义(χ^(2)=3.968,P<0.05)。两组不良反应总发生率对比,差异无统计学意义(P>0.05)。结论在rTMS治疗基础上,老年脑卒中合并吞咽障碍患者联合早期吞咽功能分级康复训练,对自身神经功能及吞咽功能均有显著改善作用,且安全性高。
Objective To study the clinical application value of high-frequency repetitive transcranial magnetic stimu-lation(rTMS)combined with early graded rehabilitation of swallowing function on nerve and swallowing function in el-derly patients with stroke complicated with dysphagia.Methods A total of 70 elderly stroke patients with dysphagia admitted to the Third People's Hospital of Taizhou from January 2021 to January 2023 were conveniently selected as the research objects and were divided into control group(n=35,routine treatment)and observation group(n=35,rTMS combined with early swallowing function grading rehabilitation training)according to the random number table method.The tongue movement(hyoid bone upward distance,hyoid bone forward distance),the scores of neurological function[National Institutes of health stroke scale(NIHSS)],swallowing function[Standard Swallowing Function As-sessment Scale(SSA)]and quality of life[swallowing quality of life(SWAL-QOL)]were compared between the two groups before and after treatment.The incidence of adverse reactions in the two groups was analyzed.Results Com-pared with before treatment,the distance of hyoid bone upward movement,hyoid bone forward movement,and SWAL-QOL score increased in both groups after treatment,while the NIHSS score and SSA score decreased,the observation group was better than those of the control group,and the differences were statistically significant(all P<0.05).The to-tal effective rate of the observation group(97.14%)was higher than that of the control group(82.86%),and the differ-ence was statistically significant(χ^(2)=3.968,P<0.05).There was no statistically significant difference in the total inci-dence of adverse reactions between the two groups(P>0.05).Conclusion On the basis of rTMS treatment,elderly stroke patients with dysphagia disorder combined with early graded rehabilitation training of swallowing function can significantly improve their own nerve function and swallowing function,and it is safe.
作者
戚峰
孟明
QI Feng;MENG Ming(Department of Neurology,Taizhou Third People's Hospital,Taizhou,Jiangsu Province,225300 China)
出处
《中外医疗》
2024年第7期18-22,共5页
China & Foreign Medical Treatment
关键词
脑卒中
吞咽障碍
高频重复经颅磁刺激
早期吞咽功能分级康复训练
吞咽功能
Stroke
Dysphagia
High-frequency repetitive transcranial magnetic stimulation
Early graded rehabilitation training of swallowing function
Swallowing function
