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目的:周围性舌下神经麻痹的临床诊治率较低,相当一部分患者未能得到及时而正确的康复治疗。本文旨在报道颈动脉内膜剥脱术致周围性舌下神经麻痹的综合康复治疗方法及临床疗效。方法:2016年3月1日,天津医科大学总医院康复医学科收入1例颈动脉内膜剥脱术致周围性舌下神经麻痹患者,对该患者进行包括舌肌运动训练、神经肌肉电刺激疗法和远红外线治疗在内的为期15 d的综合康复治疗及口服神经营养药物治疗。回顾性分析诊治过程,并对相关文献进行复习。结果:接受综合康复治疗15 d后,舌肌较治疗前灵活,构音较治疗前清晰,吞咽时对食团的控制能力和搅拌能力均得到改善;伸舌虽然仍略向右偏斜,但舌正中沟与正中线的夹角较治疗前减少17.5°;右侧舌体表面皱褶减少,舌体饱满红润;舌尖向上可触及上嘴唇;向左舔嘴角时费力程度减轻;向右伸舌时颈部肌肉张力明显降低;向口腔内部卷曲舌尖可触及软腭边缘。康复治疗效果令人满意。结论:周围性舌下神经麻痹的康复治疗方法鲜见报道。在口服神经营养药物的基础上,同时应用舌肌运动训练、神经肌肉电刺激疗法和远红外线治疗在内的康复治疗方法,可以有效地改善患者的舌肌运动功能和舌肌萎缩程度,成为改善周围性舌下神经麻痹的安全而有效的康复治疗方法。
Objective: Peripheral hypoglossal nerve paralysis clinical diagnosis and treatment rate is low, a considerable number of patients failed to get timely and correct rehabilitation. This article aims to report the comprehensive rehabilitation of peripheral hypoglossal nerve paralysis caused by carotid endarterectomy and its clinical efficacy. METHODS: On March 1, 2016, 1 case of peripheral hypoglossal nerve paralysis caused by carotid endarterectomy was enrolled in the Rehabilitation Medicine Department of General Hospital of Tianjin Medical University. The patients included tongue muscle training, neuromuscular electrical stimulation And far-infrared treatment, including a comprehensive 15 days of rehabilitation and oral neurotrophic drug treatment. Retrospective analysis of the diagnosis and treatment process, and review the relevant literature. Results: After 15 days of comprehensive rehabilitation treatment, the tongue muscle was more flexible than before treatment. The articulation of the tongue muscle was better than that before treatment. The control ability and stirring ability of the tongue during swallowing were improved. Although the tongue extension was still slightly deviated to the right, The angle between the median groove of the tongue and the median line was reduced by 17.5 ° compared with that before treatment; the surface of the right side of the tongue was reduced in surface folds; the tongue was full of redness; the tip of the tongue reached the upper lip; the strain was relieved when the mouth was licked to the left; When the neck muscle tension was significantly reduced; to the inner mouth of the oral curl tongue touches the soft palate edge. Rehabilitation treatment is satisfactory. Conclusion: The rehabilitation of peripheral hypoglossal nerve paralysis has rarely been reported. On the basis of oral neurotrophic drugs, the simultaneous application of rehabilitation therapy methods such as tongue muscle exercise training, neuromuscular electrical stimulation therapy and far-infrared treatment can effectively improve the tongue muscle function and tongue atrophy degree of the patient and become an improvement Surrounding hypoglossal nerve paralysis safe and effective rehabilitation treatment.