| 程婷,郝文杰,李祥,何望生,魏涛华,杨文明.电刺激联合吞咽功能训练治疗肝豆状核变性吞咽障碍的临床观察[J].中国康复,2022,37(8):451-455 |
| 电刺激联合吞咽功能训练治疗肝豆状核变性吞咽障碍的临床观察 |
| Clinical Observation of Electrical Stimulation Combined with Swallowing Function Training in Treating Hepatolenticular Degeneration with Dysphagia |
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| DOI： |
| 中文关键词: 肝豆状核变性 电刺激 吞咽障碍 功能训练 |
| 英文关键词: hepatolenticular degeneration electrical stimulation dysphagia functional training |
| 基金项目:国家自然科学基金面上项目（81973825）；安徽中医药大学第一附属医院优秀青年基金（院发［2019］118号）；安徽医科大学临床医学院校级科学研究项目（2020XJ017） |
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| 中文摘要: |
| 目的：评价Vitalstim型电刺激仪联合吞咽功能训练治疗肝豆状核变性患者吞咽障碍的疗效。方法：按照随机数字表法将安徽中医药大学第一附属医院60例肝豆状核变性伴吞咽障碍住院患者分为对照组和研究组各30例，对照组仅予以常规驱铜治疗，研究组患者在常规驱铜治疗基础上联合应用神经肌肉电刺激，治疗前后分别采用Gugging吞咽功能评估量表（GUSS）、视频透视吞咽功能检查（VFSS）和洼田饮水试验(WST试验)，评判两组患者吞咽功能改善情况,同时采用ELISA法比较治疗前后2组患者血清白介素-6（IL-6）、白介素-10（IL-10）及肿瘤坏死因子-α(TNF-α)数值水平变化。评判患者临床疗效的同时观察患者不良反应发生情况。结果：2组治疗1个月后GUSS及VFSS评分均较治疗前升高（均P＜0.05）、WST评分均较治疗前降低（均P＜0.05）；研究组治疗后GUSS及VFSS评分均较对照组升高（均P＜0.05），WST评分较对照组降低（P＜0.05）。对照组患者治疗后IL-6及TNF-α较治疗前降低明显（P＜0.05），IL-10较治疗前降低，但差异无统计学意义；研究组患者治疗后IL-6、IL-10、TNF-α较治疗前及对照组均明显降低（均P＜0.05）。治疗后，研究组总有效率明显高于对照组（83.3%、66.7%，P＜0.05）。研究组不良反应发生率明显低于对照组（10.0%、16.7%，P＜0.05）。结论：Vitalstim型电刺激仪协同吞咽功能训练治疗肝豆状核变性伴吞咽障碍患者能有效改善患者吞咽功能，减少误吸和感染情况的发生,大大提高患者生活质量。 |
| 英文摘要: |
| Objective: To evaluate the efficacy of VitalStim Electrical Stimulator combined with swallowing function training in the treatment of dysphagia in patients with hepatolenticular degeneration.Methods: According to the random number table method, 60 hospitalized patients with hepatolenticular degeneration complicated with dysphagia in the First Affiliated Hospital of Anhui University of Chinese Medicine were divided into control group and experimental group, 30 cases in each group. The control group was only given conventional copper expelling therapy, while the experimental group was given neuromuscular electrical stimulation and swallowing function training on the basis of conventional copper expelling therapy.GUSS scale, WST test and VFSS were used to evaluate the improvement of swallowing function in 2 groups on the first day of treatment and at the end of 4 weeks of treatment, respectively. Meanwhile, ELISA was used to compare the changes of serum IL-6, IL-10 and TNF-α before and after treatment. Observe the occurrence of adverse reactions whileevaluating the clinical efficacy of patients. Results: After treatment, GUSS score and VFSS score in 2 groups were significantly increased as compared with those before tre-atment, with statistical significance (P<0.05); WST score was decreased as compared with that before treatment, with statistical significance (P<0.05). The GUSS score and VFSS score were higher and the WST score was lower in the experimental group than in the control group after treatment, and differences were statistically significant (P<0.05). The serum levels of IL-6, IL-10 and TNF-α in hepatolenticular degeneration were significantly increased, and the levels of IL-6, IL-10 and TNF-α in both groups were decreased after treatment as compared with those before treatment (P<0.05). The levels of IL-6, IL-10 and TNF-α in the experimental group were significantly decreased as compared with those in the control group (P<0.05). After treatment, the effective rate in the experimental group was 83.3%, significantly higher than that in the control group (66.7%). Conclusion: Vitalstim electrical stimulation instrument combined with swallowing function training can effectively improve the swallowing function of patients with hepatolenticular degeneration with swallowing disorder, reduce the occurrence of aspiration and infection, and greatly improve the quality of life of patients. |
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