目的 观察呼吸训练联合低频电刺激对脑卒中后吞咽功能障碍患者的吞咽功能及呼吸功能的影响。方法 选取2018-04至2019-08我院收治的102例脑卒中后吞咽功能障碍患者为研究目标,按随机数字表法分为对照组和观察组,每组51例,对照组采用常规治疗即吞咽功能训练,观察组在对照组基础上加用呼吸训练与低频电刺激。采用洼田饮水试验评价两组临床疗效,以呼气峰流速(PEF)、一秒用力呼气量(FEV)、用力肺活量(FVc)、吞咽功能为观察指标,判断并比较两组患者的治疗效果。结果 治疗前观察组患者和对照组患者的肺功能测定PEF、FEV1、FVC三项指标均差异无统计学意义,治疗1个月后观察组患者PEF=5.46±1.01(L/s),FEV₁=2.92±0.59(L/s),FVC=3.76±0.83(L),较治疗前三项指标明显增高(P＜0.05),而对照组患者治疗后PEF=4.27±0.94(L/s),FEV₁=2.38±0.66(L/s),FVC=2.67±0.61(L),较治疗前相比基本没有变化,观察组肺功能改善情况明显优于对照组(P＜0.05);治疗前观察组患者和对照组患者的吞咽造影检查(VFSS)评分差异无统计学意义,治疗1个月后,两组患者的VFSS评分较治疗前相比均明显提高(P＜0.05),且观察组(VFSS=9.01±0.67)显著高于对照组(VFSS=7.98±0.87)(P＜0.05);治疗后观察组患者的治疗显效率84.31%,对照组患者的显效率为60.78%,观察组的治疗效果明显高于对照组(P＜0.05)。结论 在吞咽功能训练的基础上加以呼吸训练联合低频电刺激能够明显改善脑卒中后吞咽功能障碍患者的吞咽功能和呼吸功能,促进神经功能重塑,治疗效果较好。

Objective To observe the effect of respiratory training combined with low-frequency electrical stimulation on swallowing function and respiratory function of patients with dysphagia after stroke.Methods One hundred and two patients with dysphagia after stroke admitted to our hospital between April 2018 and August 2019 were selected as the subjects and divided into the control group and the observation group using the random number table method, with 51 cases in each. The control group received conventional treatment, namely, swallowing function training, while the observation group additionally received breathing training and low-frequency electrical stimulation.The clinical efficacy of the two groups was evaluated by the bottom-field drinking water test, and the therapeutic effect in the two groups was assessed and compared with PEF, FEV, FVC and swallow function as observation indexes.Results There was no significant difference in pulmonary function measurements of PEF, FEV₁ and FVC between the two groups before treatment (P>0.05). After one month of treatment, the pulmonary function of the observation group was as follows: PEF=5.46±1.01(L/s), FEV₁=2.92±0.59(L/s), and FVC=3.76±0.83(L), which were significantly higher than 4.27±0.94(L/s), FEV₁=2.38±0.66(L/s) and FVC=2.67±0.61(L)in the control group (P＜ 0.05). Lung function in the observation group was more significantly improved than in the control group (P＜0.05).There was no significant difference in the score of VFSS between the two groups before treatment. After one month of treatment, the score of VFSS in both groups was significantly higher (P＜0.05), especially in the observation group (VFSS=9.01±0.67).After treatment, the apparent therapeutic efficiency of the observation group was 84.31%, compared with 60.78% in the control group. The therapeutic effect of the observation group was significantly better than that of the control group (P＜0.05).Conclusions On the basis of swallowing function training, breathing training combined with low-frequency electrical stimulation can significantly improve the swallowing function and respiratory function of patients with swallowing function dysfunction after stroke, promote the remodeling of nerve function, and have a good therapeutic effect.