廖明霞，刘云诗，窦祖林，朱媛媛，史发林，韦章诚，杨春光，闫天凌，王栋华.经口与经鼻导尿管球囊扩张术治疗脑干卒中后环咽肌失弛缓症的影响[J].中华物理医学与康复杂志,2017,39(4):279-282
扫码阅读全文
|
| 经口与经鼻导尿管球囊扩张术治疗脑干卒中后环咽肌失弛缓症的影响 |
|
| |
| DOI： |
| 中文关键词: 球囊扩张术 环咽肌失迟缓症 吞咽障碍 脑卒中 |
| 英文关键词: Balloon dilation Cricopharyngeal achalasia Dysphagia Stroke |
| 基金项目:四川省医学会科研课题计划（S15054） |
|
| 摘要点击次数: 2613 |
| 全文下载次数: 3510 |
| 中文摘要: |
| 目的比较经口与经鼻导尿管球囊扩张术治疗脑卒中后环咽肌失弛缓症患者的疗效。 方法选取脑卒中后环咽肌失弛缓患者30例，按随机数字表法将其分为经口扩张组和经鼻扩张组，每组患者15例。2组均给予常规吞咽康复训练，在此基础上，经口扩张组通过口腔置管行导尿管球囊扩张术，经鼻扩张组给予经鼻腔插管行导尿管球囊扩张术。记录2组患者在行扩张治疗时监测患者心率变化，并于每次治疗结束后观察2组患者鼻黏膜出血、水肿、疼痛等并发症的发生情况。采用吞咽疗效评分和视频吞咽造影检查（VFSS）对2组患者治疗前、后的吞咽功能进行评估和比较。 结果治疗后，经口扩张组的藤岛一郎吞咽疗效评分为（7.26±2.52）分，经鼻扩张组为（7.18±2.64）分，分别与组内治疗前比较，差异均有统计学意义（P<0.05），2组间差异无统计学意义（P>0.05）；治疗后，2组患者的VFSS评分分别为（2.26±0.46）分和（2.19±0.53）分，分别与组内治疗前比较，差异均有统计学意义（P<0.05），2组间差异无统计学意义（P>0.05）。治疗过程中，经口扩张组心率较组内治疗前增加（9.12±1.4）次，明显低于经鼻扩张组的（18.6±2.9）次，差异有统计学意义（P<0.05），且经口扩张组治疗接受率为98.2%，明显高于经鼻扩张组80.1%，差异有统计学意义（P<0.05）。经口扩张组患者发生黏膜出血、喉头水肿、疼痛等并发症分别为1例、1例、（1.0±0.7）分，分别与经鼻扩张组的9例、7例、（3.1±0.4）分比较，差异均有统计学意义（P<0.05）。 结论导尿管球囊扩张术是脑卒中后环咽肌失弛缓所导致吞咽障碍的有效治疗方法，经口腔置管行球囊扩张术的患者的鼻黏膜水肿、喉头水肿、疼痛等并发症均优于经鼻置管行球囊扩张术的患者，且患者接受率更高。 |
| 英文摘要: |
| Objective To compare the effect of treating cricopharyngeal achalasia in stroke survivors using transnasal or transoral balloon dilatation. MethodsThirty stroke survivors with cricopharyngeal achalasia were randomly divided into a transnasal and a transoral balloon dilatation group (group N and group O), each of 15. Both groups were given routine swallowing rehabilitation training as well as the transnasal or transoral balloon dilatation. Their heart rate was monitored during the dilatation. Nasal bleeding, mucous membrane swelling and pain were also observed. Their swallowing function was evaluated using the Fujishima Ichiro swallowing efficacy score (FISE) and videofluoroscopy (VFSS) before and after the intervention. Results After the treatment, the average FISE and VFSS scores of both groups had improved significantly compared to before the treatment but there were no significant differences between the groups. During the treatment, the average heart rate of group O increased significantly less than that of group N. The treatment acceptance of group O was 98.2%, significantly higher than that of group N (80.1%). One case of mucosal bleeding was observed in group O, and laryngeal edema occurred significantly less often than in group N (9 cases vs. 7). The average pain score was also significantly lower in group O. ConclusionsBalloon dilatation facilitates swallowing among stroke survivors with cricopharyngeal achalasia. The transoral approach can help to reduce the occurrence of complications such as mucosal bleeding, laryngeal edema and pain, and has better patient acceptance. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
