《中国康复理论与实践》

《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (11): 1016-1018.

• 论文 • 上一篇    下一篇

综合康复对卒中后吞咽障碍及卒中后肺炎的影响

朱海暴，周黎，张冠文，李晏，王彦春，于永红，姜健慧，赵艳会   

  1. 河北省承德市中心医院神经内科，河北承德市067000。
  • 收稿日期:2012-08-20 修回日期:2012-09-13 出版日期:2012-11-25 发布日期:2012-11-25

Effect of Acupuncture, Neuromuscular Electrical Stimulation and Swallowing Training on Acute Stroke Patients with Dysphagia and Incidence of Post-stroke Pneumonia

ZHU Hai-bao, ZHOU Li, ZHANG Guan-wen, et al.   

  1. Department of Neurology, Chengde Central Hospital, Chengde 067000, Hebei, China
  • Received:2012-08-20 Revised:2012-09-13 Published:2012-11-25 Online:2012-11-25

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被引次数

26

摘要： 目的观察针刺、神经肌肉电刺激、吞咽训练对脑卒中后吞咽障碍的疗效及对卒中后肺炎发生率的影响。方法伴有吞咽障碍的脑卒中患者分为：训练组(n=188)，接受普通吞咽训练；电刺激组(n=196)，接受神经肌肉电刺激及吞咽训练；综合组(n=112)，接受中医针刺、神经肌肉电刺激及吞咽训练。比较治疗前及治疗后3 周吞咽评分、肺炎发生率及国立卫生研究院卒中量表(NIHSS)评分的改善值，随访出院后3 个月内新发肺炎发生率。结果治疗后，综合组吞咽障碍治疗有效率高于训练组(P<0.01)及电刺激组(P<0.05)，治疗期间肺炎发生率低于训练组(P<0.01)及电刺激组(P<0.05)，出院后3 个月新发肺炎的发生率3 组间无显著性差异(P>0.05)；综合组NIHSS 评分改善值高于训练组(P<0.01)及电刺激组(P<0.05)。结论针刺、神经肌肉电刺激及吞咽训练联合治疗能明显改善脑卒中患者的吞咽功能，减少急性期肺炎发生率。

关键词: 脑卒中, 肺炎, 吞咽障碍, 针刺, 神经肌肉电刺激, 吞咽训练

Abstract: Objective To observe the effect of acupuncture, neuromuscular electrical stimulation and swallowing training on acute stroke patients with dysphagia and the incidence of post-stroke pneumonia (PSP). Methods Acute stroke patients with dysphagia were divided into 3 groups. Routine group (n=188) received routine swallowing training. Stimulation group (n=196) received routine swallowing training and neuromuscular electrical stimulation. Acupuncture group (n=112) received routine swallowing training, neuromuscular electrical stimulation, and acupuncture. The incidence of improvment of dysphagia and PSP, and the improvement of National Institutes of Health Stroke Scale (NIHSS) within 3 weeks were compared. They were followed up for 3 months for the incidence of PSP. Results The incidence of improvment of dysphagia was the most in the acupuncture group (P<0.05), while the incidence of PSP was the least (P<0.05). The improvement of NIHSS was the most in the acupuncture group (P<0.05). The incidence of PSP was not significantly different (P>0.05) within 3 months followed up. Conclusion The acupuncture, neuromuscular electrical stimulation and swallowing training combination can improve the swallowing function and decrease the incidence of PSP in stroke patients with dysphagia.

Key words: stroke, pneumonia, dysphagia, acupuncture, neuromuscular electrical stimulation, swallowing training