摘要： 目的 探讨吞咽功能训练联合低频电刺激术对缺血性卒中患者吞咽障碍的疗效。方法 共68 例缺血性卒中合并吞咽障碍患者，分别予常规吞咽功能训练（包括吞咽训练和进食策略训练，对照组）及常规吞咽功能训练联合低频电刺激术（联合治疗组），于治疗前和治疗后15 d，采用视频透视吞咽检查（VFSS）和标准吞咽功能评价量表（SSA）评价患者吞咽功能。结果 34 例予以常规吞咽功能训练，英国牛津郡社区脑卒中项目（OCSP）分型完全前循环梗死型（TACI 型）12 例、部分前循环梗死型（PACI型）8例、后循环梗死型（POCI型）10例、腔隙性梗死型（LACI型）4例；34例予以常规吞咽功能训练联合低频电刺激术，OCSP 分型TACI 型10 例、PACI 型7 例、POCI 型11 例、LACI 型6 例。与治疗前相比，两组患者治疗后VFSS 评分增加（P = 0.003，0.000）、SSA 评分减少（P = 0.003，0.000）；与对照组相比，联合治疗组患者VFSS 评分增加（P = 0.004）、SSA 评分减少（P = 0.020）。结论 吞咽功能训练联合低频电刺激术对急性缺血性卒中患者吞咽障碍具有较好疗效，优于单纯吞咽功能训练。

关键词: 卒中, 吞咽障碍, 电刺激疗法, 康复

Abstract: Objective  To investigate the effects of swallowing training combined with low-frequency electrical stimulation on dysphagia after ischemic stroke.  Methods  A total of 68 patients with dysphagia after ischemic stroke were divided into control group (N = 34, receiving swallowing training and feeding strategies) and combined treatment group (N = 34, receiving swallowing training, feeding strategies and low-frequency electrical stimulation). Video Fluoroscopic Swallowing Study (VFSS) and Standardized Swallowing Assessment (SSA) were used to evaluate the swallowing function of patients in 2 groups before and after 15 d of treatment. Results According to Oxfordshire Community Stroke Project (OCSP) classification, 34 patients in control group were classified into 12 cases with total anterior circulation infarct (TACI), 8 cases with partial anterior circulation infarct (PACI), 10 cases with posterior circulation infarct (POCI) and 4 cases with lacunar infarct (LACI); 34 patients in combined treatment group were classified into 10 cases with TACI, 7 cases with PACI, 11 cases with POCI and 6 cases with LACI. Compared with before treatment, the VFSS score increased (P = 0.003, 0.000), while SSA score decreased (P = 0.003, 0.000) in both groups. Compared with control group, the VFSS score increased (P = 0.004), while SSA score decreased (P = 0.020) in combined treatment group.  Conclusions  Swallowing training combined with low-frequency electrical stimulation can significantly improve the swallowing capacity of patients with acute ischemic stroke, and the effect is better than mere swallowing training.

Key words: Stroke, Deglutition disorders, Electric stimulation therapy, Rehabilitation