球囊扩张术治疗老年脑卒中后环咽肌失弛缓症的疗效观察

Curative effect of balloon dilatation therapy on cricopharyngeal achalasia in elderly cerebral stroke patients

目的观察球囊扩张术治疗老年脑卒中后环咽肌失弛缓症所致吞咽功能障碍的疗效。方法选择环咽肌失弛缓症患者32例,分为治疗组18例和对照组14例。治疗组给予球囊扩张术及常规吞咽康复治疗,对照组仅给予常规吞咽康复治疗。分别在治疗前后进行吞咽功能洼田饮水试验分级评价及电视X线透视吞咽功能造影检查(VFSS)。结果治疗组和对照组患者吞咽功能洼田饮水试验分级均较治疗前好转,治疗组总有效率明显优于对照组(66.7%vs 35.7%,P<0.05);2组环咽肌开放情况较治疗前改善,且治疗组改善幅度明显优于对照组(P<0.05);治疗组治疗后5ml浓流质吞咽通过时间较治疗前明显缩短[(0.16±0.08)s vs(0.22±0.04)s,P=0.018]。结论球囊扩张术结合常规吞咽康复治疗对老年脑卒中患者环咽肌失弛缓症所致吞咽功能障碍具有显著疗效,可降低误吸等不良并发症的发生。

Objective To observe the the curative effect of balloon dilatation therapy on cricopha- ryngeal achalasia in elderly cerebral stroke patients. Methods Thirty-two cerebral stroke patients with cricopharyngeal achalasia were divided into treatment group （n= 18） and control group （n= 14）. Patients in treatment group underwent balloon dilatation therapy and routine swallowing re- habilitation treatment, those in control group received only routine swallowing rehabilitation treatment. Their swallowing function was assessed according to the water drinking test and VFSS before and after treatment. Results The water drinking test showed that the swallowing function was significantly improved both in treatment group and in control group after treatment. The total effective rate of balloon dilatation therapy was significantly higher in treatment group than in con trol group （66.7% vs 35.70% ,P〈0. 05）. The opening amplitude of cricopharyngeal muscle was greater in treatment group than in control group （P〈0.05）. The mean time for the bolus to pass pharynx was significantly shorter after treatment than before treatment （0.16±0.08 s vs 0. 22±0.04 s, P = 0. 018）. Conclusion Balloon dilatation therapy in combination with routine swallo- wing rehabilitation treatment is significantly effective on cricopharyngeal achalasia in elderly cere- bral stroke patients and can reduce the incidence of complications.