肉毒毒素注射联合球囊扩张治疗慢性脑卒中后环咽肌功能障碍的疗效研究  

Study on effect of botulinum toxin injection combined with balloon dilatation in the treatment of cricopharyngeal muscle dysfunction after chronic stroke

作　　者：赵瀛 晏正梅 陆巧妙 杨俊 施爱群 洪红 ZHAO Ying;YAN Zheng-mei;LU Qiao-miao(Department of Rehabilitation Medicine,Jinhua Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine,Jinhua 321017,China)

机构地区：[1]浙江中医药大学附属金华中医院康复医学科,321017

出　　处：《中国实用医药》2020年第36期1-3,共3页China Practical Medicine

基　　金：金华市科学技术局基金项目(项目编号:2019-4-063)。

摘　　要：目的探讨肉毒毒素注射联合球囊扩张治疗慢性脑卒中后环咽肌功能障碍的临床疗效。方法10例慢性脑卒中后环咽肌功能障碍患者,随机分为治疗组和对照组,各5例。对照组单纯给予球囊扩张治疗,治疗组给予环咽肌肉毒毒素注射联合球囊扩张治疗。观察比较两组治疗前后胃管留置情况、标准吞咽功能评价量表(SSA)评分、电视透视吞咽功能检查(VFSS)评分、Rosenbek渗漏/误吸量表(PAS)评分、改良Barthel指数(MBI)评分。结果治疗4周后,两组SSA评分均低于治疗前,且治疗组SSA评分(18.4±4.8)分低于对照组的(23.9±1.2)分,差异有统计学意义(P<0.05)。治疗4周后,两组VFSS、PAS、MBI评分均优于治疗前,且治疗组VFSS、PAS评分均优于对照组,差异有统计学意义(P<0.05),治疗组与对照组的MBI评分比较,差异无统计学意义(P>0.05)。两组治疗前后胃管留置率比较,差异均无统计学意义(P>0.05)。结论针对慢性脑卒中后环咽肌功能障碍患者采用环咽肌肉毒毒素注射联合球囊扩张治疗,其临床疗效优于单独使用球囊扩张治疗,可更好的缓解吞咽功能障碍,提升患者的日常生活能力。Objective To discuss the clinical efficacy of botulinum toxin injection combined with balloon dilatation in the treatment of cricopharyngeal muscle dysfunction after chronic stroke.Methods A total of 10 patients with cricopharyngeal muscle dysfunction after chronic stroke were randomly divided into treatment group and control group,with 5 cases in each group.The control group was treated with balloon dilatation,and the treatment group was treated with botulinum toxin injection combined with balloon dilatation.The gastric tube indwelling conditions,standardized swallowing assessment(SSA)score,video fluoroscopic swallowing study(VFSS)score,penetration-aspiration scale(PAS)score,modified Barthel index(MBI)score before and after treatment were observed and compared between the two groups.Results 4 weeks after treatment,SSA score of the two groups were lower than those before treatment,and SSA score(18.4±4.8)points of the treatment group was lower than(23.9±1.2)points of the control group,and the difference was statistically significant(P<0.05).4 weeks after treatment,VFSS,PAS and MBI score of the two groups were better than those before treatment,and the treatment group was better than the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in MBI score between treatment group and control group(P>0.05).There was no statistically significant difference in the number of gastric tube indwelling between the two groups before and after treatment(P>0.05).Conclusion For patients with cricopharyngeal muscle dysfunction after chronic stroke,cyclopharyngeal muscle toxin injection combined with balloon dilation has better clinical efficacy compared with that of balloon dilation alone,which can better alleviate swallowing dysfunction and improve the ability of daily life of patients.

关 键 词：肉毒毒素 球囊扩张疗法 脑卒中 吞咽障碍 环咽肌 

分 类 号：R743.3[医药卫生—神经病学与精神病学]