球囊扩张联合神经肌肉电刺激对脑干受损后环咽肌失弛缓症的疗效观察

Effect of Balloon Dilatation Combined with Neuromuscular Electrical Stimulation for Cricopharyngeal Achalasia in Patients with Brainstem Lesion

目的:探讨球囊扩张联合神经肌肉电刺激对脑干受损后环咽肌失弛缓症的临床疗效。方法:将48例脑干受损后环咽肌失弛缓吞咽障碍患者随机分为对照组和联合组各24例,对照组给予常规康复训练,联合组则在此基础上应用球囊扩张术联合神经肌肉电刺激,治疗4周或患者恢复经口进食后观察两组临床疗效、功能性经口摄食量表(FOIS)等级及吞咽造影检查分析结果。结果:治疗后,联合组总有效率为91.67%,显著高于对照组的62.50%(P<0.05);联合组FOIS评级、咽通过时间(PTT)改善程度均显著优于对照组(P<0.05)。结论:球囊扩张联合神经肌肉电刺激对脑干受损后环咽肌失弛缓症疗效显著,可以有效改善患者的吞咽功能及营养摄入状况,提高康复预后效果。

Objective:To investigate the clinical efficacy of balloon dilatation combined with neuromuscular electrical stimulation for cricopharyngeal achalasia in patients with brainstem lesion.Methods:48 cases of patients with cricopharyngeal achalasia and dysphagia after stroke were randomly divided into control group(24 cases)and combined group(24 cases),the patients in the control group were given routine rehabilitation training,while the patients in the combined group were given balloon dilatation therapy and neuromuscular electrical stimulation on the basis of the control group,observed the efficacy,grade of functional oral intake scale(FOIS)and the analysis results of videofluoroscopic swallowing study of the two groups after 4 weeks of treatment or the patient resuming an oral diet.Results:After treatment,the overall response rate of combined group was 91.67%,which was significantly higher than 62.50%that of control group(P<0.05);the improvement of FOIS grade and pharyngeal transit time(PTT)of combined group were significantly better than those of control group(P<0.05).Conclusion:Balloon dilatation combined with neuromuscular electrical stimulation has a significant effect for cricopharyngeal achalasia in patients with brainstem lesion.