電針在腦幹中風後吞嚥困難之治療經驗

在腦幹中風病人中，吞嚥困難是一極常見的後遺症，一般臨床經驗認為這類病人在吞嚥訓練上比左右大腦中風病人困難，預後也比較差。為了加速吞嚥困難的改善，本研究設計了一套電針吞嚥治療方式，在上廉泉、承漿、風府、和啞門四穴下針，使用低頻疏密波電刺激，配合吞嚥訓練。治療前後以電視螢光攝影吞嚥檢查，分別評估食團形成、舌頭向後功能、吞嚥反射、食物經口咽時間、異物吸入、咽部滲入、和估計每口成功吞入的食物量七項吞嚥功能。此訓練方式嘗試使用於三例腦幹中風合併吞嚥困難病人，結果發現三例在舌頭向後功能、吞嚥反射、和估計每口成功吞入的食物量方面有明顯進步，經口進食量顯著增加，其中一例最後成功拔除鼻胃管。

關鍵字

吞嚥困難；電針；腦幹中風

並列摘要

The intracarotid sodium amytal (ISA) procedure, introduced by Wada in 1949, is used to identify cerebral dominance for language and memory function in preparation for epilepsy surgery such as unilateral temporal lobectomy . Five cases with complex partial seizure, four boys and one girl, were included in this study, Their ages of onset ranged from 3 to11 years old. Frequency of seizure ranged from 2 to3 fits per month to 50 to 60 fits per day. Four cases were right-handers, one case was left-hander. All of them had normal intelligence. MRI scan of three cases showed positive findings, In continuous EEG/video monitoring, epileptogenic foci were over right temporal region in four cases, and over left temporal region in one case, ISA procedure revealed left speech dominance in four cases and right speech dominance in one case, As to cerebral dominance for memory function, there were no significant lateralization regarding both verbal and nonverbal memory in four cases. Four cases, three with left speech dominance and one with right sreech dominance, finally recrived unilateral temporal lobectomy with partial removal of hippocampus contralateral to the speech dominant hemisphere. There were neither aphasia noted postoperatively, which gave indirect evidence to the accuracy of ISA procedure. Severity of seizure reduced markedly in these four cases after operation.

並列關鍵字

dysphagia ； electroacupuncture ； brain stem stroke

被引用紀錄

謝文祥（2003）。以良導絡評估不同電刺激模式於酸痛症之療效〔碩士論文，中原大學〕。華藝線上圖書館。https://doi.org/10.6840/cycu200300665

國際替代計量

電針在腦幹中風後吞嚥困難之治療經驗

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