目的探讨咽部冷刺激联合吞咽治疗仪治疗对脑干梗死吞咽困难患者脑血流的影响，并评价其疗效。方法脑干梗死吞咽困难患者75例。按入院顺序分为康复组41例和对照组34例，并选择57例同期体检的健康人(健康组)作为健康对照，康复组和对照规组均在神经内科按脑梗死常规处理，以药物治疗为主。康复组在此基础上应用咽部冷刺激联合吞咽治疗仪治疗。治疗前后和健康组均应用TCD检测双侧椎动脉（RVA、LVA）和基底动脉（BA）的平均血流速度（VD）。结果治疗前两组与健康组比较显著降低（<0.01），康复组与对照组比较无显著性差异（>0.05）；治疗30d后康复组与健康组无差异（>0.05），康复组较治疗前增加（<0.01），较对照组明显增加（<0.01）；对照组较治疗前明显增加(<0.05)，但与健康组比较仍降低（<0.05）。结论早期咽部冷刺激联合吞咽治疗仪治疗可以增加脑干梗死吞咽困难患者的脑血流量，促进功能恢复，TCD可以作为评价其早期疗效的指标。%Objective To observe the effect of early throat cold stimulation combined swallowing therapy device on cerebral blood flow of patient with dysphagia fol owing brainstem infarction and evaluate the outcome and markers of early throat cold stimulation combined swallowing therapy device.Methods Sevevty-five patients with dysphagia fol owing brainstem infarction hemiplegia fol owing cerebral infarction were divided into rehabilitation group(n=41)and control group(n=34)consecutively.Fifty-seven healthy volunteers at the period served as healthy control groups.The patients in rehabilitation group were treated with drug and throat cold stimulation combined swallowing therapy device,and those in control group only with drug.The average cerebral blood flow of bilateral vertebral artery and base arterial in rehabilitation group, control group and health control group was examined by using transcranial Doppler.Results The average cerebral blood flow of bilateral vertebral artery and base arterial in rehabilitation and control groups was less than in healthy control group ( <0.0l)before treatment,that of rehabilitation group was not dif erent than control group.After treatment 30d,the average cerebral blood flow of bilateral vertebral artery and base arterial in rehabilitation group was not dif erent than healthy control groups ( >0.05), but obviously higher as compared with that before treatment and control group ( <0.0l).The average cerebral blood flow of bilateral vertebral artery and base arterial in control group was obviously higher than that before treatment ( <0.05),but obviously less than that of healthy control group ( <0.05).Conclusion The early throat cold stimulation combined swal owing therapy device can increase the average cerebral blood flow of bilateral vertebral artery and base arterial in patients with with dysphagia fol owing brainstem infarction and accelerate the functional restoration.TCD can be regarded as an early marker to evaluate the early outcomer.
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