神经肌肉电刺激联合经颅直流电刺激对脑卒中急性期吞咽功能障碍病人的影响

池婷; 潘桦飞; 臧云; 柯冬冬

神经肌肉电刺激联合经颅直流电刺激对脑卒中急性期吞咽功能障碍病人的影响

Effects of neuromuscular electrical stimulation combined with transcranial direct current stimulation on dysphagia in acute stroke patients

摘要

摘要:
目的： 探讨神经肌肉电刺激（neuromuscular electrical stimulation，NMES）联合经颅直流电刺激（transcranial direct current stimulation，tDCS）对脑卒中急性期吞咽障碍病人吞咽功能的影响。
方法： 选取90例脑卒中急性期吞咽障碍病人，随机分为NMES组（A组），tDCS组（B组）、NMES联合tDCS组（C组），每组各30例。采用食物残留分级（YPR）、Rosenbek渗漏/误吸评分标准（PAS）和标准吞咽评估量表（Standardized Swallowing Assessment，SSA）评估病人的吞咽功能。
结果： 治疗后，3组病人的吞咽功能较治疗前均有明显改善（P ＜ 0.05）。C组改善效果明显优于A组和B组（P ＜ 0.05），A组和B组改善效果差异无统计学意义（P ＞ 0.05）。
结论： NMES联合tDCS治疗可有效改善脑卒中急性期吞咽障碍病人的吞咽功能，降低误吸风险。

Abstract:
Objective To investigate the effects of neuromuscular electrical stimulation (NMES) combined with transcranial direct current stimulation (tDCS) on dysphagia in acute stroke patients.
Methods Ninety patients with acute stroke dysphagia were randomly divided into NMES group (group A), tDCS group (group B), and NMES combined with tDCS group (group C), with 30 patients in each group. The swallowing function of patients was evaluated using the Yale pharyngeal residue severity rating scale (YPR), Rosenbek penetration-aspiration scale (PAS), and standardized swallowing assessment (SSA).
Results After treatment, the swallowing function of patients in the three groups significantly improved compared to before treatment (P ＜ 0.05), the improvement effect in group C was significantly better than that in group A and group B (P ＜ 0.05), but the difference in improvement effect between group A and group B was not statistically significant (P ＞ 0.05).
Conclusions The combination of NMES and tDCS therapy can effectively improve the swallowing function of patients with acute stroke dysphagia and reduce the risk of aspiration.

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