高频重复经颅磁刺激对后遗症期脑卒中后吞咽功能障碍的疗效观察(1)
摘 要：目的 探讨高频重复经颅磁刺激对后遗症期脑卒中后吞咽功能障碍患者疗效。方法 选取2017年1月～2018年6月本院收治的40例后遗症期脑卒中后吞咽功能障碍患者为研究对象，采用电脑产生随机数字法将患者分为观察组和对照组，各20例。两组患者均接受常规吞咽功能训练，观察组患者在此基础上加用经颅磁刺激治疗，对照组患者接受同样刺激参数的假刺激线圈给予的治疗，比较两组患者吞咽功能评分及环咽肌表面肌电图最大波幅变化情况。结果 治疗后，对照组、观察组患者吞咽功能评分分别为(4.10±0.59)分、(4.65±0.64)分，差异无统计学意义(P>0.05)；环咽肌表面肌电图最大波幅值分别为(668.00±39.33)μV、(761.00±43.61)μV，組间比较，差异无统计学意义(P>0.05)。结论 高频重复经颅磁刺激对后遗症期脑卒中后吞咽功能障碍患者的吞咽功能无明显改善。
关键词：重复经颅磁刺激；脑卒中；吞咽功能障碍；表面肌电图
中图分类号：R743.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.028
, 百拇医药
文章编号：1006-1959(2018)22-0104-03
Therapeutic Effect of High Frequency Repetitive Transcranial Magnetic Stimulation on Deglutition Disorders after Sequelae Stroke
BAO Na-na1，LIU Chao2
(1.Institute of Neurological Diseases，North Sichuan Medical College，Nanchong 637000，Sichuan，China；
2.Department of Neurology，Affiliated Hospital of North Sichuan Medical College，Nanchong 637000，Sichuan，China)
, 百拇医药
Abstract：Objective To investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation in patients with deglutition disorders after stroke in sequelae.Methods 40 patients with deglutition disordersafter stroke in our hospital from January 2017 to June 2018 were enrolled. The patients were divided into observation group and control group by computer-generated random number method.20 cases each. Both groups of patients received routine swallowing function training.The patients in the observation group were treated with transcranial magnetic stimulation. The patients in the control group received the same stimulation parameters and the stimulation was given. The swallow function scores and the maximal amplitude of the surface electromyogram of the pharyngeal muscle were compared between the two groups. Results After treatment， the swallowing function scores of the control group and the observation group were(4.10±0.59)score and (4.65±0.64)score， respectively，the difference was not statistically significant (P>0.05).The maximum amplitude of the surface electromyogram of the pharyngeal muscle was (668.00±39.33)μV， (761.00±43.61)μV， and there was no significant difference between the groups(P>0.05). Conclusion High-frequency repetitive transcranial magnetic stimulation has no significant improvement in swallowing function in patients with deglutition disorders after sequelae.
, 百拇医药
Key words：Repetitive transcranial magnetic stimulation；Stroke；Deglutition disorders；Surface electromyography
吞咽功能障碍(deglutition disorders)是脑卒中患者常见并发症。据统计，41%～78%的脑卒中患者合并吞咽功能障碍[1]。吞咽功能障碍不仅直接影响患者进食、进饮，导致患者营养不良和水电解质紊乱；还可引起误吸、误咽，导致患者肺部感染，严重时危及生命。经颅磁刺激是一种快速起效的一种神经调控技术。研究表明，高、低频重复经颅磁刺激(repetitive transcranial magnetic stimulation，rTMS)对急性期、亚急性期脑卒中后吞咽功能障碍均有良好疗效，但对后遗症期患者是否有效，尚存在争议[1-3]。因此，本研究对高频rTMS对后遗症期脑卒中后吞咽功能障碍患者吞咽功能及其表面肌电图的影响进行了探讨，现报道如下。, 百拇医药(包娜娜 刘超)
关键词：重复经颅磁刺激；脑卒中；吞咽功能障碍；表面肌电图
中图分类号：R743.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.028
, 百拇医药
文章编号：1006-1959(2018)22-0104-03
Therapeutic Effect of High Frequency Repetitive Transcranial Magnetic Stimulation on Deglutition Disorders after Sequelae Stroke
BAO Na-na1，LIU Chao2
(1.Institute of Neurological Diseases，North Sichuan Medical College，Nanchong 637000，Sichuan，China；
2.Department of Neurology，Affiliated Hospital of North Sichuan Medical College，Nanchong 637000，Sichuan，China)
, 百拇医药
Abstract：Objective To investigate the efficacy of high-frequency repetitive transcranial magnetic stimulation in patients with deglutition disorders after stroke in sequelae.Methods 40 patients with deglutition disordersafter stroke in our hospital from January 2017 to June 2018 were enrolled. The patients were divided into observation group and control group by computer-generated random number method.20 cases each. Both groups of patients received routine swallowing function training.The patients in the observation group were treated with transcranial magnetic stimulation. The patients in the control group received the same stimulation parameters and the stimulation was given. The swallow function scores and the maximal amplitude of the surface electromyogram of the pharyngeal muscle were compared between the two groups. Results After treatment， the swallowing function scores of the control group and the observation group were(4.10±0.59)score and (4.65±0.64)score， respectively，the difference was not statistically significant (P>0.05).The maximum amplitude of the surface electromyogram of the pharyngeal muscle was (668.00±39.33)μV， (761.00±43.61)μV， and there was no significant difference between the groups(P>0.05). Conclusion High-frequency repetitive transcranial magnetic stimulation has no significant improvement in swallowing function in patients with deglutition disorders after sequelae.
, 百拇医药
Key words：Repetitive transcranial magnetic stimulation；Stroke；Deglutition disorders；Surface electromyography
吞咽功能障碍(deglutition disorders)是脑卒中患者常见并发症。据统计，41%～78%的脑卒中患者合并吞咽功能障碍[1]。吞咽功能障碍不仅直接影响患者进食、进饮，导致患者营养不良和水电解质紊乱；还可引起误吸、误咽，导致患者肺部感染，严重时危及生命。经颅磁刺激是一种快速起效的一种神经调控技术。研究表明，高、低频重复经颅磁刺激(repetitive transcranial magnetic stimulation，rTMS)对急性期、亚急性期脑卒中后吞咽功能障碍均有良好疗效，但对后遗症期患者是否有效，尚存在争议[1-3]。因此，本研究对高频rTMS对后遗症期脑卒中后吞咽功能障碍患者吞咽功能及其表面肌电图的影响进行了探讨，现报道如下。, 百拇医药(包娜娜 刘超)