神经肌肉电刺激联合咽部冰刺激治疗脑卒中后吞咽障碍的疗效观察(1)
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【摘要】 目的 探讨神经肌肉电刺激联合咽部冰刺激治疗脑卒中后吞咽障碍的疗效观察。方法 2009年1月至2011年2月收治的符号入选标准脑卒中后吞咽障碍患者198例，分为常规治疗组90例，联合治疗组108例，观察两组临床疗效。结果 联合治疗组总有效率90.74%，常规治疗组总有效率70.00%，以P<0.05为差异有统计学意义。结论 脑卒中后吞咽困难是因为梗死或出血损害了舌咽、迷走和舌下神径的核性或核下性损害产生的真性球麻痹和/(或)双侧皮质脑干束损害产生的口、咽、喉食管的神经功能紊乱。神经肌肉电刺激联合咽部冰刺激治疗脑卒中后吞咽障碍是一种安全有效、简便易行、无痛无创的治疗方法，具有成功率高、疗程短、整体治疗费用低，显著提高了患者的生存质量及生活质量。
【关键词】 神经肌肉电刺激联合咽部冰刺激;脑卒中后吞咽障碍;疗效观察
Neuromuscular electrical stimulation to stimulate joint throat ice dysphagia after stroke treatment efficacy DUAN Qin-song.Department of nehabilitation,The first People’s Hospital of Shangqiu,Shangqiu 476100,China
【Abstract】 Objective To investigate the neuromuscular electrical stimulation to stimulate joint throat ice dysphagia after stroke treatment efficacy.Methods January 2009 February 2011 symbols inclusion criteria were treated stroke patients with dysphagia after 198 cases divided into the conventional treatment group, 90 patients combined treatment group, 108 cases were observed in clinical efficacy.Results The combined treatment group was 90.74% efficiency, the efficiency of conventional treatment group was 70.00%, compared P<0.05 for the difference was significant.Conclusion Dysphagia after stroke is due to infarction or hemorrhage damage the glossopharyngeal, vagus and hypoglossal nuclear diameter of God or damage resulting Nucleation true palsy and, brainstem or bilateral cortical damage produced by the mouth beam,pharynx, larynx and esophagus of neurological disorders.Neuromuscular electrical stimulation treatment to stimulate joint throat ice dysphagia after stroke is a safe and effective, simple, painless non-invasive treatment, with a high success rate, short duration, low overall cost of treatment, significantly improve the patientsquality of life and quality of life.
【Key words】 Neuromuscular electrical stimulation to stimulate joint throat ice; Dysphagia after stroke; Efficacy
脑卒中是老年常见病多发病，具有高致残率，高病死率。脑卒中常常出现吞咽困难、构音障碍、饮食、饮水呛咳等吞咽障碍，脑卒中后吞咽障碍的发生率为30%～50%，误吸发生率为40%～70%，容易导致不良预后，如肺炎、脱水、营养不良、甚至死亡，显著影响卒中患者的生活质量。我们采用神经肌肉电刺激疗法(neuromuscular electric stimulation，NMES)联合咽部冰刺激治疗取得良好的临床效果，现汇报如下：
1 资料与方法
1.1 入选标准 选取符合1995年全国第四届脑血管疾病学术会议修订的脑卒中标准[1]，排除标准为延髓及咽部肌群病变，急性应激状态。如严重感染；合并肝、肾及造血系统严重原发疾病；冠心病、心绞痛、心肌梗死、严重的心功能不全及重度的高血压患者；精神病、严重的外伤及手术后 ......
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