导尿管球囊扩张术治疗神经源性环咽肌失弛缓症的疗效观察  

Therapeutic effects of catheter balloon dilatation therapy for neurogenic cricopharyngeal achalasia

作　　者：王珺[1] 冯珍[1] 徐华平[1] 

机构地区：[1]南昌大学第一附属医院康复医学科,南昌330006

出　　处：《中华物理医学与康复杂志》2013年第9期727-730,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察导尿管球囊扩张术对神经源性环咽肌失弛缓症所致吞咽障碍的疗效。方法将32例神经源性环咽肌失弛缓患者按随机数字表法分为治疗组和对照组，每组16例。治疗组给予导尿管球囊扩张术及常规吞咽康复训练，对照组仅给予常规吞咽康复训练。2组患者均于治疗前、治疗3周后（治疗后）和治疗结束6个月后随访（随访时）参照才藤吞咽障碍7级评价法和视频吞咽造影检查进行评定。结果治疗后，治疗组痊愈5例（31％），显效8例（50％）；对照组痊愈1例（7％），显效5例（31％），2组比较，差异有统计学意义（P〈0．05）。随访时，治疗组痊愈5例（31％），显效9例（56％）；对照组痊愈1例（7％），显效6例（38％），2组比较，差异有统计学意义（P〈0．05）。治疗后，治疗组咽通过时间为（0．15±0．05）s，与组内治疗前的（O．27±0．04）s以及对照组治疗后的（0．22±0．03）s比较，差异均有统计学意义（P〈0．05）。随访时，治疗组咽通过时间为（0．14±0．07）s，与对照组随访时的（0．21±0．04）s，组间比较，差异有统计学意义（P〈0．05）。结论导尿管球囊扩张术治疗神经源性环咽肌失弛缓症所致吞咽障碍近期及远期疗效显著。Objective To investigate the effects of catheter balloon dilatation on patients with dysphagia caused by nenrogenic cricopharyngeal achalasia. Methods Thirty-two patients with dysphagia caused by neurogenic cricopharyngeal achalasia were divided randomly into a treatment group （n ： 16） and a control group （n = 16）. The treatment group received catheter balloon dilatation therapy and routine dysphagia rehabilitation training; the control group was treated with routine dysphagia rehabilitation training only. Both groups were tested before treatment, after 3 weeks of treatment （after treatment） and at 6 months after treatment （follow-up）. All cases were evaluated using Saitoh＇s 7-grade swallowing assessment and videofluoroscopy. Results After treatment, 5 cases in the treatment group had been cured （31%） and 8 cases showed marked effectiveness （50%） ; in the control group, 1 case was cured （7%） and 5 cases showed marked effectiveness （31% ）. These differences were statistically significant. At follow-up, 5 cases in the treatment group had been cured （31%） and 9 cases showed marked effectiveness （56%） ; for the control group, 1 case was cured （7%） and 6 cased showed marked effectiveness （38%）. Those differences were also statistically significant. After treatment and also at follow-up, the average time for a bolus to pass the pharynx in the treatment group was significantly shorter than that in the control group. Conclusion Catheter balloon dilatation therapy is effective for treating neurogenic cricopharyngeal achalasia in both the short and long term.

关 键 词：导尿管球囊扩张 环咽肌失弛缓症 吞咽障碍 视频吞咽造影 吞咽 

分 类 号：R743.3[医药卫生—神经病学与精神病学]