冷热交替球囊导管扩张术在脑卒中后环咽肌失弛缓症的临床应用  

Clinical Application of Alternating Hot and Cold Balloon Dilatation in Patients with Cricopharyngeal Achalasia after Stroke

作　　者：余秀芳[1] 付高勇[1] 江铸 吕鑫 YU Xiu-fang;FU Gao-yong;JIANG Zhu;LV Xin(Department of Rehabilitation Medicine,The First People's Hospital of Yibin,Yibin,Sichuan 644000;Department of Radiology,The First People's Hospital of Yibin,Yibin,Sichuan 644000)

机构地区：[1]宜宾市第一人民医院康复医学科,四川宜宾644000 [2]宜宾市第一人民医院放射科,四川宜宾644000

出　　处：《按摩与康复医学》2021年第14期37-39,42,共4页Chinese Manipulation and Rehabilitation Medicine

摘　　要：目的:探讨冷热交替球囊导管扩张术治疗脑卒中后环咽肌失弛缓症所致吞咽障碍的应用效果。方法:将70例环咽肌失弛缓症患者随机分为试验组和对照组各35例,均接受常规康复治疗(包括吞咽功能训练、摄食训练),试验组采用冷热交替球囊导管进行经口扩张治疗,对照组采用常温球囊导管进行经口扩张治疗,于治疗前后比较两组患者标准吞咽功能评估量表(SSA)评分、视频吞咽造影(VFSS)评分、Rosenbek渗透/误吸评分、并发症发生率及扩张次数。结果:治疗后两组SSA评分、VFSS评分、Rosenbek渗透/误吸评分均优于治疗前(P<0.05),但组间差异均无统计学意义(P>0.05);试验组并发症发生率、扩张次数低于对照组(P<0.05)。结论:两种球囊导管扩张术方式均可有效治疗脑卒中后环咽肌失弛缓导致的吞咽障碍,有效改善患者吞咽功能;与常温球囊扩张治疗相比,冷热交替球囊扩张可明显减少并发症和治疗次数。Objective:To investigate the clinical application of alternating hot and cold balloon dilatation in the treatment of dysphagia caused by cricopharyngeal achalasia after stroke.Methods:70 stroke patients with cricopharyngeal achalasia were randomly divided into test group(n=35) and control group(n=3 5).Both groups received routine rehabilitation treatment,including swallowing function training and feeding training.The test group was treated with cold and hot alternate balloon for oral dilatation,the control group was treated with normal temperature balloon for oral dilatation.To evaluate the Standard Swallowing Function Assessment Scale(SSA) score,Video swallowing angiography(VFSS) score,Rosenbek score,complication rate and dilation times before and after treatment.Results:Compared with the SSA score,VFSS score and Rosenbek score were better than before treatment(P<0.05),there was no statistically significant difference between groups(P>0.05).The complication rate and dilation times of test group was lower than that of control group(P<0.05).Conclusion:Both methods of balloon dilatation can effectively treat dysphagia caused by achalasia of circumpharyngeal muscle after stroke and effectively improve patients’ swallowing function;compared with normal temperature balloon dilatation treatment,hot and cold balloon dilatation treatment can significantly reduce the occurrence of complications and reduce the dilation times.

关 键 词：环咽肌失弛缓症 脑卒中 球囊扩张术 冷热刺激 吞咽障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]