咽期吞咽障碍的诊断和治疗

Diagnosis and management of pharyngeal dysphagia

目的:综合运用不同吞咽障碍的诊断方式筛选出咽期吞咽功能异常患者,根据适应证选择不同的治疗方法并观察疗效。方法:通过不同的吞咽功能评估手段筛选出吞咽功能异常患者,根据相应适应证,分别行吞咽功能训练、环咽肌球囊扩张术、环咽肌切断术,并在术后3个月再次进行吞咽功能评估。结果:共计纳入咽期吞咽功能障碍患者100例,其中接受吞咽功能训练者75例,接受食管入口球囊扩张术者21例,接受环咽肌切断术者4例。治疗后3个月总有效率为68.00%,其中球囊扩张术组有效率为76.19%,环咽肌切断术组为75.00%,吞咽功能训练组为65.33%,各组间疗效差异无统计学意义(χ2=0.983,P>0.05)。结论:咽期吞咽障碍患者根据发病原因和程度选择吞咽功能训练、食管入口球囊扩张术及环咽肌切断术均有一定疗效。

Objective：To evaluate the effects of different managements on the patients with pharyngeal dysphagia.Method：One hundred patients with pharyngeal dysphagia were recruited for this study.They were divided into three groups after evaluation of swallow function.Then the patients in each groups received treatments include oropharyngeal strengthening exercises,esophageal entrance balloon dilation and cricopharyngeal myotomy,respectively.After 3months of treatment,the swallow function of the patients was evaluated again to determine the efficacy of the treatments.Result：Seventy-five patients received oropharyngeal strengthening exercises,21 patients received esophageal entrance balloon dilation and 4patients received cricopharyngeal myotomy.After 3months of treatment,the effective rates of three groups were 65.33%,76.19% and 75.00%,respectively,with a total efficacy of 68.00%.There was no significant difference of the treatment efficacy among three groups（χ2=0.983,P〉0.05）.Conclusion：Pharyngeal dysphagia can be improved after selected treatments according to the causes and severity of the disease.