脑卒中后吞咽困难的康复与治疗

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1、脑卒中后吞咽困难的康复与治疗摘要目的使用个体化康复训练治疗、针灸、神经肌肉电刺激治疗仪相结合的治疗方法治疗脑卒中后吞咽困难，观察临床疗效，探究脑卒中患者发生吞咽困难的治疗手段以及康复方法。方法选取146名脑卒中后经吞咽功能评定后诊断为吞咽困难的患者，随机分为两组，每组各73人，分别命名为实验组和对照组，两组患者在年龄和性别、卒中类型、病变部位及病程等方面经统计学分析无明显差异(PV0.05)。两组均给予四医对症基础治疗和个体化康复治疗，实验组在对照组的基础上结合针灸和低频电刺激治疗，观察、比较两组的治疗效果。结果观察组73例，治愈38例(52.05%

2、),有效27例(36.99%),无效8例(10.96%),总有效人数65例(89.04%),对照组73例,治愈23例(31.51%),有效33例(45.21%),无效17例(23.29%),总有效人数56例(76.72%),观察组的临床疗效明显优于对照组P=0.006(v0.05)。吞咽造影评分均较治疗前高(PV0.05),且观察组的口腔期和咽腔期吞咽造影评分高于对照组(PV0.05)。结论1•采用个体化康复训练治疗、针灸、神经肌肉电刺激治疗仪相结合的方法治疗脑卒中后吞咽困难的临床疗效显著。2.采用个体化康复训练治疗、针灸、神经肌肉电刺激治疗仪相结合

3、的治疗方法为脑卒中后吞咽困难的康复治疗提供新的方法、思路和研究方向。关键i司：吞咽困难；脑卒中；康复；针灸；神经肌肉电刺激RehabilitationandtreatmentofdysphagiaafterstrokeAbstractObjective:Dysphagiatreatmentmethodusingindividualizedtreatmentofrehabilitationtraining,acupuncture,nerveandmuscleelectricalstimulationtherapeuticapparatuscombine

4、dtherapyafterstroke,clinicalobservation,inquiryofstrokepatientswithdysphagiatreatmentandrehabilitationmethod.Methods146strokeafterswallowingfunctionassessmentafterthediagnosisofdysphagiapatients,randomlydividedintotwogroups,eachgroupofeach73people,werenamedastheexperimentalgrou

5、pandthecontrolgroup,thepatientsinthetwogroupsintermsofageandsex,stroketype,lesionlocationandcourseofdiseasehadnosignificantdifferencebystatisticalanalysis(p<0.05).Thetwogroupsweregivenwesternmedicinefoundationtreatmentandindividualizedrehabilitationtherapy,theexperimentalgroupi

6、nthecontrolgroupbasedonthecombinedacupunctureandlowfrequencyelectricstimulationtherapy,observation,comparedwithtwogroupsofcurativeeffect.Resultsintheobservationgroupof73cases,38caseswerecured(52.05%),effective27cases(36.99%),invalid8cases(10.96%),thetotaleffectivenumberof65case

7、s(89.04%),73casesofthecontrolgroup,23caseswerecured(31.51%),effective33cases(45.21%)，invalid17cases(23.29%),56thetotaleffectivenumberofcases(76.72%),clinicalefficacyisbetterthantheobservationgroupinthecontrolgroup(<0.05p=0.006).Swallowingangiographyscoreswerehigh(p<0.05),andthe

8、observationgroupoforalandpharyngealcavityphaseofswallo