BTX-A注射唾液腺改善脑卒中流涎症的临床研究

目的 观察BTX-A注射唾液腺改善脑卒中流涎症的临床疗效和安全性。方法 收集福建中医药大学附属康复医院住院的30例脑卒中后流涎的患者,按照随机数字表法随机分为治疗组15例和对照组15例。两组均给予常规吞咽康复训练12周,治疗组在常规吞咽康复训练基础上予超声引导下100U BTX-A双侧腮腺和颌下腺分别注射35U及15U。采用流涎频率评分、教师流涎分级法(TDS)、Frenchay构音障碍评定法中关于流涎的分级标准于BTX-A治疗前、治疗12周后评估各组患者的流涎程度。结果 BTX-A注射唾液腺12周后,治疗组的流涎频率评分总有效率明显高于对照组的(P＜0.05)；治疗组TDS评分总有效率明显高于对照组的(P＜0.05)；治疗组Frenchay流涎评分总有效率明显高于对照组(P＜0.05)。结论 常规吞咽训练配合BTX-A注射唾液腺明显改善脑卒中吞咽障碍患者的流涎症状,是一种安全有效的治疗方法及副作用少,对改善患者形象及生活自信建立帮助巨大,值得临床上推广及应用。

Effect of BTX-A injection into the salivary glands on the treatment of salivation after stroke: A randomized controlled trial

Objective:To investigate the clinical effects of BTX-A injection into the salivary glands on the treatment of salivation with dysphagia after stroke. Methods 30 cases of poststroke patients with salivation and dysphagia were collected from the Department of neurological rehabilitation and randomly divided into treatment group and control group. Patients in the control group (n=15) were given routine swallowing rehabilitation training, while patients in the treatment group were given BTX-A bilateral parotid(35U) and submandibular gland(15U) injection under ultrasound guidance on the basis of routine swallowing rehabilitation training. Salivation frequency score/TDS/Frenchay assessment of dysarthria were used to assess the grading of salivation respectively before treatment and after 12 weeks treatment. The swallowing ability of patients were evaluated by WatianSdrinking waterStest. Results After 12 weeks of BTX-A injection into salivary glands, the total effective rate of Salivation frequency score/TDS/Frenchay assessment of dysarthria in the treatment group was significantly higher than that in the control group (P<0.05). Conclusion Routine swallowing rehabilitation training combined with BTX-A injection into salivary glands can significantly improve the salivation symptoms of patients with dysphagia after stroke. It is a safe and effective treatment and worthy of clinical promotion and application.