导尿管球囊扩张术对治疗脑卒中后环咽肌失弛缓症的疗效分析  

The efficacy analysis of balloon catheter dilation on cricopharyngeal achalasia loss after stroke treatment

作　　者：黄晓煌[1] 白伟杰[1] 凌水桥 罗卫欢 陈志标[1] 冼祖新[1] 

机构地区：[1]中山市中医院康复治疗部,广东中山528400

出　　处：《临床和实验医学杂志》2017年第12期1215-1218,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨脑卒中后环咽肌失弛缓症患者采取导尿管球囊扩张术治疗的效果,以便找到一种治疗脑卒中后环咽肌失弛缓症有效的措施。方法随机抽取2014年11月到2016年3月期间接诊的经视频吞咽造影检查(VFSS)确诊为脑卒中且有环咽肌失弛缓症的患者40例进行研究。根据随机数字法将其分为两组,各20例。对照组采取常规吞咽训练+神经肌肉电刺激vitalstim治疗,而治疗组除了实施对照组治疗方案外,还加用导尿管球囊扩张术治疗。两组患者于治疗前、治疗后7 d、治疗后14 d及治疗后3周时采取功能性经口摄食量表(FOIS)测评口腔吞咽功能,同时治疗前后均进行VFSS评定,相关结果最终采取统计学软件对比分析。结果治疗后研究组总有效率为90.00%,而对照组仅为60.00%,研究组明显比对照组高(P<0.05);两组患者治疗后吞咽通过时间、环咽肌开放情况、吞咽障碍程度和误吸率相比治疗前均有明显改善(P<0.05),但研究组改善更为明显(P<0.05);两组患者治疗后7 d、14 d、3周后POIS评分均有明显下降(P<0.05),但研究组下降更明显(P<0.05)。结论脑卒中后环咽肌失弛缓症患者采取导尿管球囊扩张术治疗,不仅能提高临床效果,而且能改善吞咽通过时间、环咽肌开放情况、吞咽障碍程度及误吸率,值得临床推广应用。Objective To explore the efficacy of balloon catheter dilation on cricopharyngeal achalasia loss after stroke treato to find a effective method of treating post - stroke cricopharyngeal achalasia. Methods 40 cases of patients from November 2014 to March 2016 were selected, who during the admissions performed via video swallowing angiography （VFSS） and were diagnosed with stroke combined with cri-copharyngeal achalasia lose. They were randomly divided into 2 groups, 20 patients in each group. The control group received conventional swallo-wing training ＋ vitalstim neuromuscular electrical stimulation therapy, and therapy group performed balloon catheter treatment in addition. Before treatment, 7 d, 14 d and 3 w after treatment, functional take oral ingestion Scale （ FOIS） were accepted to detect the oral swallowing function, and simultaneously VFSS assessment was carried out. The final results were compared with relevant statistical software. Results After treatment, the total effective rate in the study group was 90. 00% , while that in the control group was only 60. 00% , the study group was significantly higher than the control group （ P 〈0.05）. After treatment, swallowing time, cricopharyngeal open time, the degree of dysphagia and aspiration rate were sig-nificantly improved （ P 〈0.05） , but the study group improved more significantly （ P 〈 0 .0 5 ） . POIS score 7 d , 14 d , 3 weeks after treatment decreased significantly （ P 〈0.05） , but the study group decreased more significantly （ P 〈 0 .0 5 ） . Conclusion To take the catheter balloon dilation treatment in patients with stroke combined with cricopharyngeal achalasia patients, not only can improve the clinical effect, but also im-prove swallowing time, cricopharyngeal open time, the degree of dysphagia and aspiration rate. Therefore, it is worth clinical application.

关 键 词：脑卒中 环咽肌失弛缓症 导尿管球囊扩张术 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]