重复经颅磁刺激联合球囊扩张术治疗脑卒中后神经源性环咽肌失弛缓症的效果  

Effect of Repetitive Transcranial Magnetic Stimulation Combined with Balloon Dilation for Neurogenic Cricopharyngeal Muscle Achalasia After Stroke

作　　者：徐静 马登飞 张金凤 XU Jing;MA Dengfei;ZHANG Jinfeng(Department of Rehabilitation Medicine,the People’s Hospital of Anyang City,Anyang 455000,China;Department of Gastroenterology,the Fifth People’s Hospital of Anyang,Anyang 455000,China)

机构地区：[1]安阳市人民医院康复医学科,河南安阳455000 [2]安阳市第五人民医院消化内科,河南安阳455000

出　　处：《河南医学研究》2025年第4期650-653,共4页Henan Medical Research

摘　　要：目的探究重复经颅磁刺激联合球囊扩张术在脑卒中后神经源性环咽肌失弛缓症中的临床效果。方法回顾性采集安阳市人民医院2021年2月至2022年8月经球囊扩张术治疗的39例脑卒中术后神经源性环咽肌失弛缓症患者资料,纳入对照组;采集同期医院经重复经颅磁刺激联合球囊扩张术治疗的39例脑卒中术后神经源性环咽肌失弛缓症患者资料,纳入观察组。全部患者完成治疗与随访,一般资料、治疗资料、结果资料保存完整。查阅资料,记录患者手术情况;患者于治疗前、治疗6周接受视频透视吞咽检查(VFSS),以评估其吞咽功能;同时各时点接受洼田饮水试验,评价吞咽功能等级,各项评估与检查结果数据保存完整。结果观察组拔管时间与住院时间均短于对照组(P<0.05);治疗6周,两组VFSS评分升高,且观察组高于对照组(P<0.05);观察组吞咽功能恢复情况优于对照组(P<0.05)。结论重复经颅磁刺激联合球囊扩张术的实施,更利于促进脑卒中后神经源性环咽肌失弛缓症患者吞咽功能恢复,患者拔管时间与住院时间缩短,治疗效果更好。Objective To explore the clinical efficacy of repetitive transcranial magnetic stimulation combined with balloon dilation in neurogenic cricopharyngeal muscle atony after stroke.Methods Retrospective analysis was conducted to collect data from 39 patients with postoperative neurogenic cricopharyngeal muscle achalasia who underwent balloon dilation surgery in the People’s Hospital of Anyang City from February 2021 to August 2022,and included them in the control group.The data of 39 patients with postoperative neurogenic cricopharyngeal muscle achalasia after stroke treated with repetitive transcranial magnetic stimulation combined with balloon dilation in the same hospital at the same time was collected and included in the observation group.All patients completed treatment and follow-up,and baseline,treatment,and outcome data were kept intact.Information was reviewed and the patient’s surgical condition was recorded.The patient underwent video fluoroscopic swallowing study(VFSS)before treatment and 6 weeks after treatment to evaluate their swallowing function.At the same time,the Wada drinking water test was conducted at various time points to evaluate the swallowing function level,and the data of various evaluations and examination results were kept intact.Results The extubation time and hospitalization time in the observation group were shorter than those in the control group,with a statistical significant difference(P<0.05).After 6 weeks of treatment,the VFSS scores of the two groups increased,and the observation group was higher than the control group(P<0.05).The recovery of swallowing function in the observation group was better than that in the control group(P<0.05).Conclusion The implementation of repetitive transcranial magnetic stimulation combined with balloon dilation is more conducive to promoting the recovery of swallowing function in patients with neurogenic cricopharyngeal muscle achalasia after stroke,shortening the time for extubation and hospitalization,and achieving better treatment outcomes

关 键 词：脑卒中 神经源性环咽肌失弛缓症 重复经颅刺激 球囊扩张术 吞咽功能 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]