经颅直流电刺激联合情景互动呼吸训练对脑卒中吞咽困难患者营养状况及生活质量的影响OA
Effects of combination of transcranial direct current stimulation and scenario-based interactive breathing training on the efficacy,nutritional status,and quality of life of stroke patients with dysphagia
目的:探讨经颅直流电刺激(tDCS)联合情景互动呼吸训练对脑卒中合并吞咽困难患者疗效、营养状况及生活质量的影响.方法:选取脑卒中合并吞咽困难患者 150 例患者,根据随机数字表法分为 2 组各 75 例,对照组采用常规训练和情景互动呼吸训练,观察组额外联合 tDCS 治疗.对比 2 组疗效、营养状况、吞咽功能、生活质量.结果:治疗后,2 组洼田饮水试验(WST)、Gugging 吞咽功能评估量表(GUSS)评分、吞咽造影检查(VFSS)、吞咽障碍特异性生活质量量表(SWAL-QOL)评分及血清白蛋白(ALB)、转铁蛋白(TF)、前白蛋白(PA)水平均较治疗前升高(P<0.05),且观察组升高幅度优于对照组(P<0.05);营养风险筛查表(NRS-2002)评分降低(P<0.05),观察组评分低于对照组(P<0.05);观察组临床疗效明显高于对照组(P<0.05);观察组经口进食及由管饲转为经口进食的患者比例均高于对照组(P<0.05).观察组不良反应发生率为 9.33%,对照组为 5.33%,组间比较无统计学差异.结论:经颅直流电刺激联合情景互动呼吸训练对脑卒中合并吞咽困难患者的吞咽功能、营养状况及生活质量具有显著改善作用,且疗效优于单一情景互动呼吸训练,安全性良好.
Objective:To discuss the effects of combination of transcranial direct current stimulation(tDCS)and scenario-based interactive breathing training on the efficacy,nutritional status,and quality of life of stroke patients with dysphagia.Methods:From January 2022 to January 2025,150 patients with stroke complicated with dysphagia admitted to Guangzhou First People's Hospital were selected,and divided into two groups according to the random number table method.In total,75 patients in the control group received conventional training and situational inter-active breathing training,while 75 patients in the observation group were additionally treated with tDCS.The effica-cy,nutritional status,swallowing function,and quality of life were compared.Results:After intervention,the scores of Water Swallowing Test(WST),Gugging Swallowing Screen(GUSS),Videofluoroscopic Swallowing Study(VFSS),Swallowing Quality of life(SWAL-QOL),as well as the levels of serum albumin(ALB),transfer-rin(TF),and prealbumin(PA)in both groups increased compared to before intervention(P<0.05),and the in-crease amplitude in the observation group was better than that in the control group(P<0.05).The score of Nutri-tional Risk Screening-2002(NRS-2002)decreased(P<0.05),and the score of the observation group was lower than that of the control group(P<0.05).The therapeutic effect of the observation group was significantly higher than that of the control group(P<0.05).The proportions of patients who were fed orally and those who switched from tube feeding to oral feeding in the observation group were both higher than those in the control group,and there was a significant difference between the groups(P<0.05).The incidence of adverse reactions was 9.33%in the observation group and 5.33%in the control group.Conclusion:Based on conventional drug treatment and stand-ard swallowing rehabilitation training,the application of tDCS combined with situational interactive breathing train-ing can significantly improve the swallowing function,nutritional status and quality of life of patients with stroke complicated with dysphagia,and its therapeutic effect is superior to that of single situational interactive breathing training.
陈秀明;张廷碧;温璐璐;李婉萁;周元
广州市第一人民医院康复医学科,广州 510000广州市第一人民医院康复医学科,广州 510000广州市第一人民医院康复医学科,广州 510000广州市第一人民医院康复医学科,广州 510000广东省中医院康复科
医药卫生
经颅直流电刺激情景互动呼吸训练脑卒中吞咽困难营养状况
transcranial direct current stimulationscenario-based interactive breathing trainingstrokedyspha-gianutritional status
《中国康复》 2026 (9)
527-532,6
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