| 孙龚卫,杨柳,孙小星.高频rTMS作用健侧半球吞咽皮质代表区联合吞咽康复训练治疗脑卒中后吞咽障碍的临床研究[J].中国康复,2022,37(1):7-11 |
| 高频rTMS作用健侧半球吞咽皮质代表区联合吞咽康复训练治疗脑卒中后吞咽障碍的临床研究 |
| Clinical study of high-frequency repetitive transcranial magnetic stimulation on the representative area of the healthy hemisphere swallowing cortex combined with swallowing rehabilitation training in the treatment of dysphagia after cerebral apoplexy |
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| DOI： |
| 中文关键词: 重复经颅磁刺激 缺血性脑卒中 吞咽障碍 康复训练 生活质量 |
| 英文关键词: repetitive transcranial magnetic stimulation ischemic stroke dysphagia rehabilitation training quality of life |
| 基金项目:江苏省中医药科研计划课题（YB20180142） |
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| 中文摘要: |
| 目的：探讨高频重复经颅磁刺激（rTMS）作用于健侧半球吞咽皮质代表区联合吞咽康复训练治疗脑卒中后吞咽障碍的疗效。方法：将82例缺血性脑卒中后吞咽障碍患者随机分为2组。对照组（41例）采用吞咽康复训练治疗，观察组（41例）采用高频rTMS作用于健侧半球吞咽皮质代表区联合吞咽康复训练治疗，均治疗4周。观察2组疗效，吞咽障碍改善程度、生活质量差异。结果：治疗后，观察组有效率高于对照组（P＜0.05）。2组治疗后上食道括约肌（UES）开放时间、USE开放程度、咽收缩持续时间、舌骨向上位移、舌骨向前位移（HA）、功能性经口摄食量表（FOIS）评分以及饮食情况、心理压力、情绪情感状态、社会功能、交流、吞咽障碍特异性生活质量量表（SWAL-QOL）评分均较治疗前明显增加（P＜0.05），观察组治疗后上述指标高于对照组（P＜0.05）。2组治疗后误吸评分、吞咽困难程度评分、洼田饮水试验评分均较治疗前明显降低（P＜0.05），观察组治疗后上述评分明显低于对照组（P＜0.05）。结论：高频rTMS作用健侧半球吞咽皮质代表区联合吞咽康复训练均可更有效地改善缺血性脑卒中后吞咽障碍患者吞咽功能，提高患者生活质量，效果优于单纯吞咽康复训练。 |
| 英文摘要: |
| Objective: To investigate the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on the representative area of the healthy hemisphere swallowing cortex combined with swallowing rehabilitation training in the treatment of dysphagia after cerebral apoplexy. Methods: A total of 82 patients with dysphagia after ischemic stroke admitted to our hospital from March 2019 to March 2021 were selected and divided into two groups by random number table method. The control group (41 cases) was treated with swallowing rehabilitation training for 1 month, and the observation group (41 cases) was treated with high frequency rTMS on the representative area of the healthy hemisphere swallowing cortex combined with swallowing rehabilitation training for 1 month. The curative effect, improvement degree of dysphagia and quality of life were observed and compared between the two groups. Results: The effective rate of observation group was higher than that of control group (P<0.05). After treatment, upper esophageal sphincter (UES) opening time, USE opening degree, pharyngeal contraction duration, hyoid vertical displacement (HV), hyoid anterior displacement (HA), scores of functional oral intake scale (FOIS) and diet, psychological stress, emotional state, social function, communication, swallowing quality of life questionnaire (SWAL-QOL) in the two groups were significantly higher than those before treatment (P<0.05), and the above indexes in the observation group were higher than those in the control group (P<0.05). After treatment, the aspiration score, dysphagia score and Wuda field drinking water test score in observation group were significantly lower than those before treatment (P<0.05), and those in the observation group were significantly lower than those in the control group (P<0.05). Conclusion: The effect of high-frequency rTMS on the representative area of the healthy hemisphere swallowing cortex combined with swallowing rehabilitation training can improve the swallowing function and the quality of life of patients with dysphagia after ischemic stroke more effectively than that of swallowing rehabilitation training alone. |
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