| Objective: To investigate the effect of pharyngeal neuromuscular electrical stimulation on dysphagia in elderly stroke patients at different stages. Methods: A total of 120 elderly stroke patients with swallowing dysfunction treated in our hospital from January 2019 to January 2023 were randomly divided into two groups. The control group was given routine swallowing function training, and the study group was added pharyngeal neuromuscular electrical stimulation on the basis of the control group. The nutritional status, neurotrophic factors, immune function, ultrasound parameters, surface electromyography (sEMG), swallowing function scores and clinical efficacy of the two groups were compared before and after treatment at different stages. Generalized estimation equation (GEE) model was used to analyze the influencing factors of clinical efficacy and the interaction effects of time point, group and stage. Results: After 4 weeks of treatment, albumin (ALB), hemoglobin (Hb), brain-derived neurotrophic factor (BDNF), nerve growth factor (nerve growth factor) NGF), insulin growth factor (insulin growth factor, IGF) -1, CD3+, CD4+, CD4+/CD8+, tongue thickness, motion range, motion velocity, maximum distance, shortening distance, shortening rate, maximum amplitude, modified Barthel index and Fujijima's swallowing efficacy score were significantly higher than those of the control group. CD8+, exercise time, minimum distance, swallowing time, standardized swallowing assessment (SSA) score were significantly lower than control group, CD4+/CD8+, maximum amplitude and modified GEE model analysis showed that treatment time and different stages significantly affected the therapeutic effect. In the interaction effect analysis, there was a significant difference in clinical efficacy between the two groups at 2 weeks of treatment, while there was a significant difference between the two groups at 4 weeks of treatment between the two groups at the middle pharyngeal stage and the mixed oropharyngeal stage. Conclusion: In the treatment of swallowing dysfunction in different stages of senile stroke, pharyngeal nerve electrostimulator is superior to conventional swallowing function training in terms of nutritional status, neurotrophic factors, immune function, parameters related to ultrasound examination, sEMG, and scores related to swallowing function, and the effect is optimal in pharyngeal stage. |