摘要
目的探讨不同方式球囊扩张治疗环咽肌失弛缓所致吞咽障碍的疗效及作用机制。方法共选取30例脑干梗死后吞咽障碍患者，经吞咽X线荧光透视检查（VFSS）均证实为环咽肌失弛缓。采用随机数字表法将其分为球囊A组、球囊B组及球囊C组（每组10例），分别采用14号普通导尿管、14号改良双腔硅胶导管和22号普通导尿管经鼻或经口插入扩张治疗。于治疗50d后对各组患者吞咽功能进行评定。结果治疗后3组患者吞咽障碍分级、VFSS检查结果均较治疗前明显改善（P〈0．05）；其中球囊A组、球囊C组吞咽障碍分级、VFSS检查结果均显著优于球囊B组（P〈0．05）；球囊A组及球囊C组间疗效差异无统计学意义（P〉0．05）。在注入相同水量情况下，球囊A组、球囊C组球囊周长、囊内压力及球囊直径均显著大于球囊B组，组间差异均具有统计学意义（P〈0．05）；球囊A组与球囊C组间差异无统计学意义（P〉0．05）。结论采用导尿管球囊扩张术治疗脑干梗死所致环咽肌失弛缓具有显著疗效，能有效缓解环咽肌失弛缓病情，改善患者吞咽功能；另外发现扩张疗效与球囊直径、囊内压力等具有明显相关性。
Objective To observe the effect of different ways of balloon catheter dilation techniques on cri- copharyngeal achalasia and its mechanisms. Methods Thirty patients with deglutition disorder after brain stern infarction, whose cricopharyngeal achalasias were proven by videofluoroseopic swallowing study（VFSS） ,were randomly divided into three groups： No. 14 conventional catheter group A, No. 14 modified bicavitary silica-gel catheter group B and No. 22 conventional catheter group C with 10 cases in each group, respectively. All the patients of 3 groups re- eeived multiple times corresponding balloon catheter dilatation per nasal or per os （ No. 22 conventional catheter group C only per os）. Results After an average of 30 d of balloon catheter dilatation, the level of dysphagia and VFSS evaluation of all patients improved significantly （ P 〈 0.05）. However, the No. 14 conventional catheter group A and No. 22 conventional catheter group C improved to a greater extent than No. 14 modified bicavitary silica-gel catheter group B （P 〈0.05）. The saccule perimeter, saccule diameter and saecule intracapsular pressure of No. 14 conventional catheter group A and No. 22 conventional catheter group C increased significantly （P 〈 0.05） when compared to those of No. 14 modified bieavitary sifica-gel catheter group B, but there was no significant diffferenee beween No. 14 conventional catheter group A and No. 22 conventional catheter group C （ P 〉 0.05 ）. Conclusions The balloon catheter dilation technique can significantly improve swallowing function of deglutition disorders patients with cricopharyngeal aehalasia after brain stem infarction, which is related positively to saccule diameter and saccule intracapsular pressure.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2011年第12期909-912,共4页
Chinese Journal of Physical Medicine and Rehabilitation
基金
河南省科技攻关计划项目资助（072102310043）
关键词
球囊扩张术
环咽肌失弛缓症
吞咽障碍
Balloon catheter dilation technique
Cricopharyngeal achalasia
Deglutition disorders
