星状神经节阻滞联合尼麦角林对脑卒中后吞咽困难的疗效观察

doi:10.11958/20241237

摘要/Abstract

摘要：

目的探讨星状神经节阻滞（SGB）联合尼麦角林对脑卒中后吞咽困难的治疗效果。方法选取卒中后吞咽困难患者104例，随机分为观察组和对照组。观察组采用尼麦角林联合SGB治疗，对照组采用功能性电刺激治疗。比较2组总有效率、吞咽情况、炎性因子水平及不良事件。结果治疗后，观察组总有效率高于对照组（92.31% vs. 73.08%，P<0.05）；观察组标准吞咽功能评价量表（SSA）评分、白细胞介素-6（IL-6）水平、肿瘤坏死因子α（TNF-α）水平低于对照组（P<0.05），曼恩吞咽能力评估量表（MASA）评分高于对照组（P<0.05）；且2组声门关闭、喉痉挛等不良反应发生率差异无统计学意义（P>0.05）。结论脑卒中后吞咽困难患者采用SGB联合尼麦角林治疗可有效改善吞咽功能，安全性良好，效果较为理想，临床应用价值较高。

关键词: 卒中, 吞咽障碍, 神经节阻滞药, 星状神经节, 尼麦角林

Abstract:

Objective To investigate the clinical efficacy of stellate ganglion block (SGB) combined with nicergoline in patients with dysphagia after stroke.Methods A total of 104 patients with dysphagia after stroke were randomly divided into the observation group and the control group. The observation group was treated with niergoline and SGB, while the control group received functional electrical stimulation. The total effective rate, swallowing condition, inflammatory factor level and adverse events were compared between the two groups.Results After treatment, the total effective rate was significantly higher in the observation group (92.31%) than that of the control group (73.08%, P<0.05). The level of interleukin-6 (IL-6), the standardized swallowing assessment (SSA) score and the level of tumor necrosis factor alpha (TNF-α) were significantly lower in the observation group than those in the control group (P<0.05). The Mann swallowing ability assessment scale (MASA) score was significantly higher in the observation group than that of the control group (P<0.05). There were no significant differences in adverse reactions such as glottis closure and laryngeal spasm between the two groups (P>0.05).Conclusion The combined treatment of SGB and nicergoline can effectively improve swallowing function in patients with dysphagia after stroke, with good safety, ideal results and high clinical application value.

Key words: stroke, deglutition disorders, ganglionic blockers, stellate ganglion, nicergoline

中图分类号:

R743.3

图/表 5

参考文献 21

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组别	性别（男/女）	年龄/岁	病程/d	卒中类型（缺血性/出血性）
对照组	31/21	63.15±6.69	15.04±2.59	34/18
观察组	28/24	63.56±6.74	15.12±2.63	30/22
χ²或t	0.353	0.311	0.156	0.650

组别	性别（男/女）	年龄/岁	病程/d	卒中类型（缺血性/出血性）
对照组	31/21	63.15±6.69	15.04±2.59	34/18
观察组	28/24	63.56±6.74	15.12±2.63	30/22
χ²或t	0.353	0.311	0.156	0.650

组别	显效	有效	无效	总有效
对照组	18（34.62）	20（38.46）	14（26.92）	38（73.08）
观察组	26（50.00）	22（42.31）	4（7.69）	48（92.31）
χ²				6.718^＊

组别	显效	有效	无效	总有效
对照组	18（34.62）	20（38.46）	14（26.92）	38（73.08）
观察组	26（50.00）	22（42.31）	4（7.69）	48（92.31）
χ²				6.718^＊

组别	SSA评分
组别	治疗前	治疗后	t
对照组	32.27±4.52	23.85±3.04	26.594^＊＊
观察组	32.35±4.56	20.63±2.43	35.707^＊＊
t	0.090	5.966^＊＊
组别	MASA评分
组别	治疗前	治疗后	t
对照组	61.21±7.05	83.02±8.76	35.226^＊＊
观察组	60.75±7.01	92.54±9.64	47.100^＊＊
t	0.334	5.270^＊＊