摘要
目的探讨星状神经节阻滞联合YS1001P治疗仪治疗急性脑梗死伴吞咽困难的临床效果。方法选取河北北方学院附属第二医院急性脑梗死伴吞咽困难患者80例,按照随机数字表法分为2组,每组40例。2组均行卒中后对症治疗,包含控制血压和血糖、抗血小板聚集、调节脂代谢、改善脑循环、营养脑神经以及并发症的防治等,在此基础上采用吞咽和神经肌电刺激仪YS1001P治疗,研究组额外行星状神经节阻滞治疗,20 d后采用洼田饮水试验评价患者临床疗效。采用藤岛一郎吞咽障碍评分和电视X线透视下吞咽造影检查(videofluroscopic swallowing study,VFSS)比较治疗前和治疗后2组的吞咽功能,比较对照组和研究组治疗前后血清神经生长因子(nerve growth factor,NGF)和脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)含量变化情况。结果治疗后,研究组藤岛一郎吞咽障碍评分高于对照组(P<0.05),口腔期、咽期、误吸评分及VFSS评分总分高于对照组(P<0.05),洼田饮水试验分级优于对照组(P<0.05),研究组治疗总有效率95.00%高于对照组77.50%(P<0.05),研究组血清NGF和BDNF含量高于对照组(P<0.05)。结论星状神经节阻滞联合YS1001P治疗仪治疗急性脑梗死伴吞咽困难的临床效果较好,患者吞咽功能改善明显,其作用机制可能与提高神经营养水平有关。
Objective To explore the clinical efficacy of stellate ganglion block combined with YS1001P therapeutic instrument in the treatment of acute cerebral infarction(ACI)with dysphagia.Methods In total,80 patients with ACI and dysphagia of the Second Affiliated Hospital of Hebei North University were enrolled in this study,and then divided into two groups according to the random number table method,with 40 patients in each group.Both groups received symptomatic treatment after stroke,including control of blood pressure and blood sugar,anti-platelet aggregation,regulation of lipid metabolism,improvement of cerebral circulation,nutrition of cranial nerves,and prevention and treatment of complications.On this basis,swallowing and neuromuscular electrical stimulator YS1001P was used for treatment.The research group received additional stellate ganglion block treatment.After 20 d,Kubota Water Swallowing Test was used to evaluate the clinical efficacy of patients.The swallowing function of patients in the two groups before and after treatment was compared with the score of Fujishima Ichiro Dysphagia scale and videofluoroscopic swallowing study(VFSS),and the changes of serum nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)before and after treatment were compared between the control group and the research group.Results After treatment,the score of Fujishima Ichiro Dysphagia scale in the research group was higher than that in the control group(P<0.05).After treatment,the scores of oral phase,pharyngeal phase,aspiration,and total VFSS scores in the research group were higher than those in the control group(P<0.05),and the grading of Kubota Water Swallowing Test in the research group was better(P<0.05).The total effective rate of 95.00%in the research group was significantly higher than 77.50%in the control group(P<0.05),and the serum NGF and BDNF levels in the research group were higher than those in the control group(P<0.05).Conclusion The combination of stellate ganglion block and YS1001P treatment instrume
作者
赵鹏
姚玉婷
贾贤达
肖志娟
李燕
沈文
ZHAO Peng;YAO Yu-ting;JIA Xian-da;XIAO Zhi-juan;LI Yan;SHEN Wen(Department of Neurology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China;Department of Function,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China;Department of Rehabilitation,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China)
出处
《河北医科大学学报》
CAS
2024年第9期1002-1006,共5页
Journal of Hebei Medical University
基金
张家口市市级科技计划项目(2221046D)。
关键词
脑梗死
吞咽困难
星状神经节阻滞
cerebral infarction
difficulty swallowing
stellate ganglion block
