經顱超聲、激光聯合神經肌肉電刺激治療對腦卒中患者生活質量與肢體功能的影響

朱智文+尹德銘+方向延+李志強

【摘要】 目的：觀察經顱超聲、激光聯合神經肌肉電刺激治療對改善腦卒中患者生活質量與肢體功能的影響。方法：選取2014年8月-2016年12月來本院治療的82例腦卒中患者，按照隨機數字表法分為治療組和對照組。對照組患者接受常規治療，觀察組患者經顱超聲、激光聯合神經肌肉電刺激治療。觀察對比兩組治療后的臨床療效、Barthel評分等級，TG、心率、血壓變化以及洼田飲水分級、藤島一郎吞咽障礙評分。結果：治療組臨床總有效率為88.1%，對照組為72.5%，治療組臨床療效明顯優于對照組（P<0.05）；治療組TG、血壓改善程度均明顯優于對照組（P<0.05）；治療組洼田飲水分級、藤島一郎吞咽障礙評分以及Barthel評分等級均明顯優于對照組（P<0.05）。結論：腦卒中患者采取經顱超聲、激光聯合神經肌肉電刺激治療具有較高的臨床價值，值得臨床推廣。

【關鍵詞】 顱超聲； 激光； 神經肌肉電刺激； 腦卒中； 療效

【Abstract】 Objective：To observe the effect of transcranial ultrasound and laser combined with neuromuscular electrical stimulation on improving the quality of life and limb function of stroke patients.Method：A total of 82 stroke patients who were treated in our hospital from August 2014 to December 2016 were selected and randomly divided into the treatment group and the control group.The patients in the control group received conventional treatment，the patients in the observation group were treated with transcranial ultrasound and laser combined with neuromuscular stimulation.The clinical efficacy，Barthel score，TG，heart rate，blood pressure change and the classification of the drinking water of two groups after the treatment were observed and compared.Result：The total effective rate of the treatment group was 88.1%，and the control group was 72.5%，the clinical curative effect of the treatment group was better than that of the control group（P<0.05）.TG and blood pressure of the treatment group were significantly better than those of the control group（P<0.05）.The scores of the drinking water grading， rattan Ichiro swallowing disorder and Barthel score of the treatment group were significantly better than those of the control group （P<0.05）.Conclusion：Transcranial ultrasonography and laser combined with neuromuscular electrical stimulation in the treatment of Stroke have a high clinical value and are worthy of clinical application.

【Key words】 Cranial ultrasound； Laser； Neuromuscular electrical stimulation； Stroke； Effect

First-authors address：The Second Peoples Hospital in Shunde District of Foshan，Foshan 528305，China

doi：10.3969/j.issn.1674-4985.2017.23.011

腦卒中是臨床最普遍的危重腦血管疾病之一，多高發于中老年，具有發病急、病情發展快的特點[1]，可迅速對患者的腦組織造成侵害，進而直接造成腦功能受損，有極高的致癱和致死率[2]，對患者的生命安全與生活質量帶來不利影響。經顱超聲能夠無創刺激患者的腦部組織，臨床常規的治療為植電極，經顱電場，近些年臨床又興起了電生理治療、激光治療等新的治療手段，顯示均可在治療腦卒中患者中收獲確切療效，但關于三者治療聯用的研究還不多。

1 資料與方法

1.1 一般資料 選取2014年8月-2016年12月來本院治療的82例腦卒中患者。患者發病48 h且生命體征穩定，血壓低于180/100 mm Hg，排除標準：大面積腦梗死；嚴重腦水腫及顱內高壓；嚴重認知障礙；腦出血及顱腦外傷顱骨骨折及顱骨手術術后。其中肢體偏癱82例，部分失語36例。……