球囊扩张术对脑卒中后吞咽障碍康复疗效及不良并发症研究  

Curative effect and adverse complications of balloon dilation for patients with dysphagia after stroke

作　　者：朱海霞[1] 李一贤 张琰[1] 尹华[2] 郝利霞[1] 王丽英[1] 白晓燕 姜妍 Zhu Haixia;Li Yisan;Zhang Yah(Inner Mongolia Medical University Hospital,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院康复科,呼和浩特010050 [2]内蒙古医科大学附属医院放射科,呼和浩特010050 [3]内蒙古医科大学,呼和浩特010050

出　　处：《中国康复》2018年第4期275-278,共4页Chinese Journal of Rehabilitation

基　　金：内蒙古自治区科技计划项目;内蒙古财政厅资助(Kjt15sf17)

摘　　要：目的:研究球囊扩张术对脑卒中后吞咽障碍的康复疗效及不良并发症的影响。方法:选取我院经吞咽造影检查确诊为脑卒中后环咽肌失弛缓导致的吞咽障碍患者50例,随机分为2组各25例。对照组接受常规吞咽功能训练、Vitalstim神经肌肉低频电刺激,观察组另外给予球囊扩张术治疗。比较2组患者的总有效率、吞咽功能、并发症发生率,同时比较治疗前和治疗后的咽通过时间、吞咽造影检查(VFSS)评分及功能性经口摄食评估(FOIS)评分。结果:观察组的可进水、可进食流质物、可进食糊状物、可进食固体食物比例均明显高于对照组(均P<0.01);观察组的吸入性肺炎发生率明显低于对照组(P<0.05);治疗后,观察组的咽通过时间明显低于对照组(P<0.01),VFSS和FOIS评分均明显高于对照组(均P<0.01);观察组的康复总有效率明显高于对照组(96.0%,72.0%,P<0.05)。结论:球囊扩张术对脑卒中后吞咽障碍具有显著疗效,缩短患者康复时间,降低误吸等并发症的发生。Objective：To study the effect of balloon dilation on the recovery of dysphagia and adverse complications in patients with dysphagia after stroke.Methods：Fifty patients who were diagnosed as having dysphagia after stroke were randomly divided into control group and observation group,25 cases in each group.The control group and observation group received the routine dysphagia rehabilitation therapy and low-frequency neuromuscular electrical stimulation.The observation group was given balloon dilatation treatment additionally.Two groups were evaluated by the total effective rate of rehabilitation,swallowing function,complication rates,the swallow time,videofluoroscopic swallowing study（VFSS）and functional oral intake scale（FOIS）before and after treatment.Results：The proportion of intakes of water,liquid food,paste food and solid food in the observation group was significantly higher than in the control group（P〈0.01）.The incidence of aspiration pneumonia in the observation group was obviously lower than in the control group（P〈0.05）.After treatment,the pharyngeal transit time in the observation group was markedly shorter than in the control group（P〈0.01）,but VFSS and FOIS scores were significantly higher than in the control group（P〈0.01）.The total effective rate in the observation group was apparently higher than in the control group（96.0% vs.72.0%,P〈0.05）.Conclusion：Balloon dilatation can obviously improve swallowing function in patients after stroke,shorten the recovery time,and reduce the incidence of complications such as aspiration.

关 键 词：球囊扩张术 脑卒中 吞咽障碍 康复效果 并发症 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]