球囊扩张术联合表面肌电生物反馈治疗环咽肌失弛缓症的临床观察  

Clinical observation of balloon dilatation combined with surface electromyography biofeedback in treatment of cricopharyngeal achalasia

作　　者：王忠林 罗君 陆敏[3] 沈俊明 陈创 杜书兰 黄明勇 Wang Zhonglin;Luo Jun;Lu Min(The Graduate School of Jinzhou Medical Universi,Jinzhou 121000,China)

机构地区：[1]锦州医科大学研究生院,辽宁锦州121000 [2]湖北医药学院附属随州医院康复科,湖北随州441300 [3]华中科技大学同济医学院附属同济医院康复科,武汉430000

出　　处：《中国康复》2023年第10期589-594,共6页Chinese Journal of Rehabilitation

基　　金：湖北省卫生健康委科研项目(WJ2021F088);随州市卫生健康委科研项目(2021SZ32014)。

摘　　要：目的:探讨在留置鼻胃管的情况下行球囊扩张术联合表面肌电生物反馈治疗环咽肌失弛缓症的临床疗效。方法:选择60例脑部疾病恢复早期环咽肌失弛缓症患者,随机分为基础组、对照组和观察组各20例,3组均进行常规治疗,包括腹式呼吸训练、门德尔松手法训练、吞咽众肌群神经肌肉低频电刺激、营养及对症支持治疗,基础组在常规治疗基础上加用球囊扩张术,对照组在常规治疗上加用球囊扩张术序贯联合表面肌电生物反馈治疗,观察组在常规治疗基础上加用球囊扩张术同时联合表面肌电生物反馈治疗。结果:治疗6周后,3组患者功能性经口进食量表(FOIS)等级,电视荧光吞咽造影检查(VFSS)评分,颏下肌群、舌骨下肌群表面肌电图肌肉均方根值(RMS),吞咽相关生存质量问卷得分(SWAL-QOL)均较治疗前明显改善(均P<0.05),且FOIS等级、VFSS评分、舌骨下肌群RMS值、颏下肌群RMS值方面,观察组优于其他2组(均P<0.05),SWAL-QOL得分组间无显著差异。3组患者治疗前后肱三头肌皮褶厚度(TSF)营养分度未见明显差异。结论:留置鼻胃管下球囊扩张术同时联合表面生物肌电反馈对脑部疾病恢复早期环咽肌失弛缓症疗效显著,依从性高,值得临床进一步推广。Objective:To investigate the clinical effects of balloon dilatation combined with surface electromyography biofeedback dwelling nasogastric tubes in cricopharyngeal achalasia.Methods:Totally,60 patients with early recovery of brain disease were selected and randomly divided into the basic,control and observation groups(n=20 each).All 3 groups received conventional treatment,including abdominal breathing training,Mendelssohn technique training,swallowing mass neuromuscular electrical stimulation,nutrition and symptomatic support therapy.Additionally,the basic group was given balloon dilatation,the control group was given balloon dilatation in sequential combination with surface electromyography biofeedback,and the observation group was given balloon dilatation in combination with surface electromyography biofeedback.Results:After 6 weeks of treatment,the functional oral intake scale(FOIS)grade,videofluoroscopic swallowing study(VFSS)scores,surface electromyogram root mean square(RMS)values of submental and subhyoid muscles and the swallowing quality of life(SWAL-QOL)scores were significantly improved in all groups as compared with those before treatment(P<0.05).In addition,the observation group was best in the FOIS grade,VFSS scores,the RMS values of submental and subhyoid muscles(P<0.05),but there were no significant differences in SWAL-QOL among three groups.All 3 groups showed no significant difference in triceps skinfold thickness before and after treatment.Conclusion:Balloon dilatation combined with surface electromyography biofeedback has significant efficacy and high compliance,for the early recovery from brain disease cricopharyngeal achalasia,which is worth further clinical promotion.

关 键 词：留置鼻胃管 球囊扩张术 表面肌电生物反馈 环咽肌失弛缓症 

分 类 号：R49[医药卫生—康复医学] R766[医药卫生—临床医学]