导管球囊扩张术结合用力吞咽法治疗老年环咽肌功能障碍的临床研究

Clinical study of catheter balloon dilatation combined with forced swallowing in elderly patients with cricopharyngeus muscle dysfunction

目的探讨导管球囊扩张术结合用力吞咽法应用于老年环咽肌功能障碍病人的疗效。方法选择经视频吞咽造影检查(VFSS)明确诊断为环咽肌功能障碍的老年病人32例,按入院顺序分为研究组和对照组,每组各16例。研究组给予导管球囊扩张术结合用力吞咽法治疗,对照组给予常规吞咽康复治疗,2组均辅以神经肌肉电刺激,分别在治疗前和恢复经口进食或治疗满6周后,利用吞咽障碍临床疗效评价标准和VFSS进行评定,分析比较2组病人吞咽功能的变化。结果治疗后,研究组有效率为93.75%,对照组有效率为75.0%,2组差异有统计学意义(P<0.05)。VFSS检查显示,治疗后2组Rosenbek分级较治疗前均有明显改善,且研究组改善更明显,差异均有统计学意义(P<0.05)。结论导管球囊扩张术结合用力吞咽法,在改善老年环咽肌功能障碍方面优于常规吞咽康复治疗。

Objective To investigate the curative effect of catheter balloon dilatation combined with forced swallowing in the elderly patients with cricopharyngeus muscle dysfunction.Methods A total of 32 elderly patients with cricopharyngeus muscle dysfunction diagnosed by video swallowing angiography(VFSS)were divided into study group and control group according to the hospitalization order,with 16 cases in each group.The study group was treated with catheter balloon dilatation combined with forced swallowing,while the control group was treated with routine swallowing rehabilitation.Both groups received neuromuscular electrical stimulation.Before treatment and after 6 weeks of oral feeding or treatment,the clinical evaluation criteria and VFSS were used to evaluate dysphagia,and the changes of swallowing function were analyzed and compared.Results The effective rate of study group was 93.75%,which was significantly higher than that of the control group(75.0%).After treatment,the VFSS examination showed the opening,leakage and aspiration of annular pharynx muscle in the two groups were significantly improved,especially in the study group(P<0.05).Conclusions Balloon dilatation combined with forced swallowing is superior to conventional swallowing rehabilitation in improving the cricopharyngeus muscle dysfunction in the elderly.