球囊扩张术治疗吞咽功能障碍的疗效观察  

The effects of balloon dilatation on swallowing dysfunction in patients with dysphagia

作　　者：丘卫红[1] 窦祖林[1] 万桂芳[1] 王晓红[2] 林嘉旋[1] 林捷新[1] 

机构地区：[1]中山大学附属第三医院康复医学科,广州510630 [2]中山大学附属第三医院放射科,广州510630

出　　处：《中华物理医学与康复杂志》2007年第12期825-828,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨球囊扩张术在环咽肌失弛缓症所致吞咽障碍中的治疗作用。方法共选取10例经吞咽X线荧光透视检查诊断为环咽肌失弛缓症的吞咽障碍患者。利用14号导尿管球囊,采用注水方式使球囊充盈以扩张环咽肌,同时辅以低频电刺激、口颜面吞咽器官运动训练及进食指导练习等。分别于治疗前、后进行吞咽功能评估。结果上述患者经平均19.7次球囊扩张治疗后,其扩张球囊注水量由(2.65±0.91)ml增加至(8.20±0.92)ml,环咽肌开放功能显著提高,吞咽障碍明显改善,共显效7例,有效2例,这9例患者能完全经口自主进食糊状食物,无呛咳,吞咽造影复查显示在进食糊状食物时,其咽部期残留明显减少,环咽肌正常开放,误吸现象消失,仅余下1例患者只能达治疗性进食水平,吞咽造影复查显示其吞咽肌无力,环咽肌开放不全,仍存在误吸现象;比较治疗前、后患者饮水试验分级及吞咽障碍分级,发现治疗前、后差异均有统计学意义(P<0.01)。结论球囊扩张术能显著改善环咽肌失弛缓导致的吞咽功能障碍,值得临床推广、应用。Objective To study the effect of balloon dilatation therapy on dysphagia caused by cricopharyngeal achalasia. Methods Ten cases of dysphagia were diagnosed as cricopharyngeal achalasia by videofluoroscopic swallowing study （VFSS）. A 14# urethral catheter was inserted into the esophagus and an amount of water was injec- ted into the balloon of the urethral catheter to make it turgid. Then the catheter was pulled upwards and passed through the stricture of esophagus to dilatate the cricopharygeus muscle. Meanwhile, low frequency electrical stimulation was used and combined with functional training of the organs related to deglutition and ingestion. The results before and after the treatment were evaluated. Results After 19.7 times of dilatation therapy, the content of water injected into the balloon was increased from 2.65 ± 0.91 ml to 8.20 ±0.92 ml. Cricopharyngeal achalasia was alleviated significantly （P 〈0.01 ）. The swallowing function was improved remarkably. Nine of the 10 patients could eat pasty food independently without bucking. Review of swallowing visualization showed that when bolus passed through entrance of esophagus the cricopharygeus muscle relaxed normally and aspiration disappeared. Only 1 of the patients was of no effect. The total effective rat was 90%. The grades of water drinking test and dysphagia test were improved significantly after training （P 〈0.01 ）. Conclusion Balloon dilatation therapy is effective in alleviating dysphagia caused by cricopharyngeal achalasia.

关 键 词：球囊扩张术 环咽肌失弛缓症 吞咽障碍 吞咽X线荧光透视检查 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R739.63[医药卫生—临床医学]