摘要目的 观察表面肌电生物反馈疗法(sEMG-BFB)联合吞咽训练对鼻咽癌放疗后吞咽障碍患者的影响.方法 选取鼻咽癌放疗后吞咽障碍患者50例,按照随机数字表法将其分为生物反馈组(25例)和常规训练组(25例).常规训练组给予口颜面功能训练、感觉刺激、吞咽行为训练及电刺激等常规康复训练.生物反馈组在此基础上,将吞咽行为训练改为在sEMG-BFB下进行.训练前、训练4周后(训练后),采用视频透视吞咽检查(VFSS)观察患者食道上括约肌(UES)的开放情况,采用渗透-误吸评分(PAS)及功能性经口摄食量表(FOIS)对患者的吞咽功能进行评估.结果 训练前,2组患者的UES开放情况、PAS及FOIS评分比较,差异均无统计学意义(P＞0.05).与组内训练前比较,2组患者训练后的UES开放情况、PAS及FOIS评分均有所改善(P＜0.05).与常规训练组比较,生物反馈组的UES开放情况较为优异、PAS较低[(2.04±0.93)分]、FOIS评分[(5.04±1.31)分]较高(P＜0.05).结论 sEMG-BFB联合吞咽训练有助于改善鼻咽癌放疗后吞咽障碍患者UES的开放情况,提高其吞咽功能,降低误吸风险.

abstractsObjective To observe the effect of surface electromyographic biofeedback (sEMG BFB) combined with routine swallow training in treating dysphagia among those with nasopharyngeal carcinoma after radiation therapy.Methods Fifty dysphagic patients with nasopharyngeal carcinoma after radiation therapy were randomly divided into a biofeedback training group and a routine treatment group,each of 25.Both groups were given routine training including orofacial function training,sensory irritation,behavioral swallowing training,and electrical stimulation.The biofeedback group was additionally given behavioral swallowing training based on sEMG BFB.Before and 4 weeks after the treatment,a videofluoroscopic swallowing study was performed to observe the opening of the upper esophageal sphincter (UES).The penetration aspiration scale (PAS) and the functional oral intake scale (FOIS) were used to evaluate the subjects' swallowing function.Results Before the treatment there were no significant differences between the two groups in terms of UES opening,average PAS score or average FOIS score.Everyone improved significantly after the treatment,but compared with the routine treatment group,UES opening was significantly better after the treatment,the average PAS score was lower and the average FOIS score was higher in the biofeedback training group.Conclusion sEMG BFB combined with routine swallowing training can improve the UES opening and swallowing ability of dysphagic patients with nasopharyngeal carcinoma after radiation therapy.