经口球囊扩张术治疗脑卒中后环咽肌失弛缓的疗效观察

Peroral catheter balloon dilatation therapy relieves cricopharyngeal achalasia after stroke

目的探讨经口球囊扩张术对脑卒中后环咽肌失弛缓的疗效。方法将32例脑卒中后环咽肌失弛缓的患者，按随机数字表法分为对照组和治疗组，每组16例。对照组给予常规吞咽康复训练，治疗组在常规康复训练的基础上增加经口球囊扩张术，疗程2周，每周6次。分别在治疗前、后采用吞咽功能评价方法和视频吞咽造影检查（VFSS）进行评定。结果治疗2周后，治疗组16例患者中有14例进食功能改善，对照组仅9例进食功能有改善，两组吞咽功能评价相比较，差异具有统计学意义（P〈0．05）。在VFSS检查中，吞咽障碍程度评分比较，两组均较治疗前提高（P〈0．05），且治疗组较对照组提高更明显，差异有统计学意义（P〈0．05）；咽通过时间比较，治疗组较治疗前明显缩短（P〈0．05），对照组治疗前后无明显差异（P〉0．05）。结论经口球囊扩张术对治疗脑卒中后环咽肌失弛缓具有显著疗效。

Objective To investigate the effects of peroral catheter balloon dilatation on patients with dysphagia caused by crieopharyngeal achalasia after stroke. Methods Thirty-two stroke survivors with erico- pharyngeal achalasia were randomly divided into a control group and a treatment group, each of 16. Both groups were given routine dysphagia rehabilitation training, but the treatment group was additionally given peroral bal- loon dilatation therapy six times a week for 2 weeks. Both groups were given swallowing function evaluations and videofluoroseopie swallowing examinations （VFSS） before and after the treatment. Results After the treat- ment, 14 of the 16 patients in the treatment group demonstrated improved swallowing, significantly better than the control group, where only 9 patients had improved. The VFSS showed dysphagia to have been relieved in both groups, hut significantly more in the treatment group. Transit duration in the pharnx was significantly shortened from 0.28 s to 0.16 s in the treatment group, but no significant difference was found in the control group. Conclusion Peroral catheter balloon dilatation is effective for relieving cricopharyngeal aehalasia after stroke.