摘要
目的探讨双侧高频重复经颅磁刺激联合高压氧治疗脑卒中后吞咽障碍效果。方法选取2022年1月至2023年3月江苏省徐州市中心医院收治的120例脑卒中后吞咽障碍患者,按照随机数字表法将其分为观察组和对照组,每组60例。对照组以单侧高频重复经颅磁刺激联合高压氧联治疗,观察组采用双侧高频重复经颅磁刺激联合高压氧治疗,两组均以2周为1个疗程,共治疗3个疗程。比较两组临床疗效,治疗前后吞咽功能评分[吞咽功能评定量表(SAA)、洼田饮水试验(KWST)、进食评估问卷调查工具-10(EAT-10)]、肌电图指标、脑损伤标志物[神经元特异性烯醇化酶(NSE)、S100钙结合蛋白β(S100β)、神经丝蛋白轻链(NF-L)]。结果观察组临床疗效优于对照组(P<0.05)。治疗后,两组SAA、KWST、EAT-10评分均低于治疗前,且观察组低于对照组(P<0.05)。治疗后,两组下颌舌骨肌表面肌电信号振幅、时程均低于治疗前,中位频率高于治疗前,且观察组下颌舌骨肌表面肌电信号振幅、时程低于对照组,中位频率高于对照组(P<0.05)。治疗后,两组NSE、S100β、NF-L均低于治疗前,且观察组低于对照组(P<0.05)。结论双侧高频重复经颅磁刺激联合高压氧治疗脑卒中后吞咽障碍的效果良好,改善吞咽障碍程度与肌电图指标,降低脑损伤标志物水平。
Objective To explore the clinical effect of bilateral high-frequency repetitive transcranial magnetic stimulation combined with hyperbaric oxygen therapy on swallowing disorders after stroke.Methods A total of 120 patients with swallowing disorders after stroke treated in Xuzhou Central Hospital of Jiangsu Province from January 2022 to March 2023 were selected,and they were divided into observation group and control group according to random number table method,with 60 cases in each group.The control group was treated with unilateral high-frequency repetitive transcranial magnetic stimulation combined with hyperbaric oxygen therapy,while the observation group was treated bilateral high-frequency repetitive transcranial magnetic stimulation combined with hyperbaric oxygen therapy.Both groups were treated with a course of two weeks and a total of three courses of treatment.The clinical efficacy of the two groups was compared.The swallowing function scores(swallowing function assessment scale[SAA],Kuwada drinking water test[KWST],eating assessment tool-10[EAT-10]),electromyography indicators,brain injury markers(neuron-specific enolase[NSE],S100 calcium-binding proteinβ[S100β],neurofilament protein light chain[NF-L])before and after treatment were compared between the two groups.Results The clinical effect of the observation group was better than that of the control group(P<0.05).After treatment,the scores of SAA,KWST,and EAT-10 in both groups were lower than those before treatment,and those of the observation group were lower than the control group(P<0.05).After treatment,the amplitude and duration of mylohyoid surface electromyography signal in both groups were lower than those before treatment,and the median frequency was higher than before treatment,and the amplitude and duration of mylohyoid surface electromyography signal in the observation group were lower than the control group,and the median frequency was higher than the control group(P<0.05).After treatment,NSE,S100β,and NF-L in both groups were lower t
作者
姚珊
郭鹏飞
孙洁
张蒙蒙
YAO Shan;GUO Pengfei;SUN Jie;ZHANG Mengmeng(Department of Rehabilitation,Xuzhou Central Hospital,Jiangsu Province,Xuzhou 221000,China)
出处
《中国医药导报》
CAS
2024年第11期51-55,共5页
China Medical Herald
基金
江苏省科技项目(BE2020638)
江苏省徐州市卫生健康委科技项目(XWKYHT20220109)。
关键词
脑卒中
吞咽障碍
双侧高频
重复经颅磁刺激
吞咽功能
表面肌电图
Stroke
Swallowing disorders
Bilateral high-frequency
Repetitive transcranial magnetic stimulation
Swallowing function
Surface electromyography
