双侧rTMS联合吞咽-摄食训练对脑卒中后吞咽障碍患者FOIS评分、吞咽安全性的影响OA
Effect of Bilateral rTMS Combined with Swallowing-Feeding Training on FOIS Score and Swallowing Safety in Patients with Post-Stroke Dysphagia
目的 探讨双侧重复经颅磁刺激(rTMS)联合吞咽-摄食训练对脑卒中后吞咽障碍(PSD)患者功能性经口摄食量表(FOIS)评分、吞咽安全性的影响.方法 回顾性收集2021年3月至2025年4月于南京同仁医院治疗的120例PSD患者的临床资料,按照治疗方法分为单一干预组(基础性吞咽-摄食训练干预,53例)和联合干预组(双侧rTMS联合个体化吞咽-摄食训练干预,67例).对比两组患者吞咽功能[FOIS评分、吞咽功能评价量表(SSA)评分、电视荧光吞咽造影(VFSS)评分]、吞咽安全性[渗漏误吸量表(PAS)评分、洼田饮水试验(WST)评分]及临床疗效.结果 干预后,两组患者FOIS评分、VFSS评分均较干预前升高,SSA评分较干预前降低,且联合干预组FOIS、VFSS评分均高于单一干预组,SSA评分低于单一干预组,差异均有统计学意义(P<0.05).干预后,两组患者PAS评分、WST评分较干预前降低,且联合干预组低于单一干预组,差异均有统计学意义(P<0.05).联合干预组总有效率为95.52%(64/67),显著高于单一干预组的77.36%(41/53),差异有统计学意义(χ2=8.926,P=0.003).结论 双侧rTMS联合吞咽-摄食训练干预可显著提高PSD患者FOIS评分及吞咽安全性,改善患者吞咽功能,疗效明显.
Objective To investigate the effect of bilateral repetitive transcranial magnetic stimulation(rTMS)combined with swallowing and feeding training on the Functional Oral Intake Scale(FOIS)score and swallowing safety in patients with post-stroke dysphagia(PSD).Methods The clinical data of 120 PSD patients treated at Nanjing Tongren Hospital from March 2021 to April 2025 were retrospectively collected and divided into a single-intervention group(basic swallowing and feeding training intervention,n=53)and a combined-intervention group(bilateral rTMS combined with individualized swallowing and feeding training intervention,n=67)according to the treatment methods.Swallowing function[FOIS score,standardized swallowing assessment(SSA)score,videofluoroscopic swallowing study(VFSS)score],swallowing safety[penetration-aspiration scale(PAS)score,water swallowing test(WST)score],and clinical efficacy were compared between the two groups.Results After the intervention,FOIS and VFSS scores increased compared with those before the intervention in both groups,while SSA scores decreased.Moreover,the combined-intervention group had significantly higher FOIS and VFSS scores and a lower SSA score than the single-intervention group,with all differences being statistically significant(P<0.05).After the intervention,PAS and WST scores decreased compared with those before the intervention in both groups,and the scores in the combined-intervention group were significantly lower than those in the single-intervention group,with statistically significant differences(P<0.05).The total effective rate in the combined-intervention group was 95.52%(64/67),which was significantly higher than that in the single-intervention group(77.36%,41/53),and the difference was statistically significant(χ2=8.926,P=0.003).Conclusion Bilateral rTMS combined with swallowing and feeding training intervention can significantly improve FOIS scores and swallowing safety in PSD patients,enhance swallowing function,and achieve marked therapeutic effects.
许密;阮成龙;王争;马文艳;徐翠琴;蔡秀娅
南京同仁医院康复科,南京 211100南京同仁医院康复科,南京 211100南京同仁医院康复科,南京 211100南京同仁医院康复科,南京 211100南京同仁医院康复科,南京 211100南京同仁医院康复科,南京 211100
重复经颅磁刺激吞咽训练摄食训练脑卒中吞咽障碍吞咽安全性
repetitive transcranial magnetic stimulationswallowing trainingfeeding trainingstrokedysphagiaswallowing safety
《转化医学杂志》 2026 (1)
15-19,5
南京同仁医院院内科研项目(2023E005)
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