本文選題：神經(jīng)肌肉電刺激 + 舌骨喉復(fù)合體運(yùn)動(dòng)速度��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:觀察不同時(shí)間的神經(jīng)肌肉電刺激(NMES)對(duì)腦卒中后吞咽障礙患者的臨床療效及舌骨喉復(fù)合體運(yùn)動(dòng)速度的影響。方法:將30例符合入選標(biāo)準(zhǔn)的腦卒中咽期吞咽功能障礙患者按隨機(jī)數(shù)字表分為對(duì)照組、NMES組和強(qiáng)化NMES組,每組各10例。3組患者均給予常規(guī)吞咽功能訓(xùn)練,在此基礎(chǔ)上NMES組給予每日1次神經(jīng)肌肉電刺激,強(qiáng)化NMES組給予每日2次神經(jīng)肌肉電刺激,共治療4周。分別于治療前、治療2周及4周后進(jìn)行視頻透視吞咽檢查(VFSS),測(cè)量舌骨、甲狀軟骨在吞咽半流質(zhì)食物時(shí)向前、向上的運(yùn)動(dòng)幅度、時(shí)間,計(jì)算運(yùn)動(dòng)速度,同時(shí)采用洼田飲水試驗(yàn)、才藤分級(jí)、Rosenbek滲透-誤吸量表(PAS)對(duì)3組患者進(jìn)行療效評(píng)定。結(jié)果:治療后,3組患者洼田飲水試驗(yàn)、才藤分級(jí)、PAS評(píng)分均較治療前明顯改善(P0.05);洼田飲水試驗(yàn)在治療2周后,強(qiáng)化NMES組、NMES組顯效率高于對(duì)照組(P0.05);才藤分級(jí)在治療2周、4周后強(qiáng)化NMES組有效率高于對(duì)照組;PAS評(píng)分在強(qiáng)化NMES組治療2周[(3.30±0.82)分]、4周[(2.10±0.88)分]后較NMES組、對(duì)照組均明顯改善,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。舌骨前移速度中強(qiáng)化NMES組在治療2周[(20.52±8.39)mm/s]、4周[(33.00±19.83)mm/s]后較NMES組及對(duì)照組增快;同時(shí)PAS評(píng)分與舌骨前移速度Pearson相關(guān)性分析呈中度相關(guān)(P0.05)。結(jié)論:強(qiáng)化NMES對(duì)于改善吞咽障礙患者吞咽功能優(yōu)于NMES,舌骨喉復(fù)合體運(yùn)動(dòng)速度增快可明顯改善吞咽障礙的治療效果。
[Abstract]:Aim: to observe the effects of neuromuscular electrical stimulation (NMES) on dysphagia and hyoid laryngeal complex motion in patients with dysphagia after stroke. Methods: thirty patients with stroke dysphagia were randomly divided into control group (n = 10) and NMES group (n = 10). On this basis, the NMES group was treated with neuromuscular electrical stimulation once a day, while the NMES group was treated with neuromuscular electrical stimulation twice a day for 4 weeks. Before treatment, 2 weeks and 4 weeks after treatment, video fluoroscopy was performed to examine the hyoid bone and thyroid cartilage. The amplitude, time and velocity of movement were measured before and 2 weeks and 4 weeks after the treatment, respectively. At the same time, the depression-drinking water test was used to measure the movement amplitude, time and velocity of the hyoid bone and thyroid cartilage in the course of swallowing half fluid food. Rosenbek osmotic and false aspiration scale was used to evaluate the curative effect of three groups of patients. Results: after treatment, the scores of sag water test and pas scores were significantly improved in the three groups than before, and after 2 weeks of treatment, the scores of pas were significantly improved in the three groups of patients, and after 2 weeks of treatment, the scores of pas were significantly improved in the three groups. The markedly effective rate of NMES group was higher than that of control group (P 0.05), the effective rate of enhanced NMES group was higher than that of control group after 2 weeks and 4 weeks of treatment, and the score of pas was significantly higher than that of NMES group after 2 weeks [3.30 鹵0.82] weeks of intensive NMES treatment [2.10 鹵0.88]. The difference was statistically significant (P 0.05). After 2 weeks of treatment [20.52 鹵8.39)mm/s] and 4 weeks [33.00 鹵19.83)mm/s], the hyoid anterior displacement velocity in the NMES group increased faster than that in the NMES group and the control group, and the correlation analysis between PAS score and hyoid anterior displacement velocity (Pearson) showed a moderate correlation (P 0.05). Conclusion: enhanced NMES can improve the swallowing function of patients with dysphagia, and the faster motion of hyoid laryngeal complex can obviously improve the therapeutic effect of dysphagia.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R743.3

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本文編號(hào)：1930819