球囊扩张术中球囊容积与吞咽功能恢复的相关性分析

Balloon capacity is correlated with efficacy in treating cricopharyngeal achalasia using balloon dilatation therapy

目的 探讨不同球囊扩张方法治疗环咽肌失弛缓症和良性狭窄的疗效，分析球囊注水容积与吞咽功能恢复的相关性。方法选择诊断为环咽肌失弛缓症患者23例与环咽肌良性狭窄7例，应用导尿管球囊扩张术分别作主动或被动扩张，辅以乔咽手法治疗、间接训练、直接训练及进食指导，采用视频吞咽造影检查及摄食-吞咽功能等级评定评价疗效与相关性。结果2种不同方式的扩张治疗方法具有不同效果。采用SPSS15．0版统计软件包进行相关性分析，球囊内注水容积与吞咽功能恢复相关系数r=0．921，P〈0．01，差异有统计学意义。吞咽造影复查显示环咽肌开放有显著改善。结论导尿管球囊扩张术是治疗环咽肌失弛缓症和良性狭窄的有效手段，球囊内注水容积与吞咽功能的恢复密切相关，辅以综合治疗措施将会获得更好的治疗效果。

Objective To investigate the efficacy of two different methods of catheter balloon dilatation therapy in treating crieopharyngeal achalasia and benign strictures, and to correlate balloon capacity with improvements in swallowing function. Methods Twenty-three cricopharyngeal achalasia patients and 7 with benign strictures of the cricopharyngeal muscles were diagnosed using videofluoroscopic swallowing study （VFSS）. All cases received active dilatation or passive balloon dilatation therapy, combined with manipulation, indirect training, direct training and feeding instruction. Efficacy and the correlation were evaluated using VFSS and a swallowing function scale. Results Passive and active dilatation had the same efficacy. The correlation coefficient between balloon capacity and swallowing function was 0. 921. Re-evaluation using VFSS showed that opening of the cricopharyngeal muscles had improved significantly. Conclusions Balloon catheter dilation is an effective treatment for cricopharyngeal aehalasia and benign strictures. The improvement in swallowing function is highly correlated with balloon capacity in balloon dilatation therapy. Comprehensive treatment for dysphagia would provide better outcomes.