球囊扩张术结合综合康复治疗脑卒中后吞咽障碍的疗效观察

目的：探讨球囊扩张术结合综合康复治疗对脑卒中后吞咽障碍患者的治疗效果。方法对20例经吞咽X线荧光透视诊断为环咽肌失弛缓症脑卒中后吞咽障碍患者，采用注水方式使12号双腔气囊导尿管球囊充盈以扩张环咽肌，并结合门德尔松、Shaker训练手法等综合手段对患者进行康复治疗。治疗前、后评估吞咽功能。结果20例患者治愈15例，有效5例；治疗后饮水试验分级评分低于治疗前，治疗后吞咽障碍分级评分高于治疗前，咽通过时间从治疗前0.28s缩短到治疗后的0.16s，差异均有统计学意义（P＜0.01）。结论球囊扩张术结合门德尔松手法、Shaker训练法等综合康复手段能显著改善脑卒中后环咽肌失弛缓导致的吞咽功能障碍。

Catheter balloon dilatation combined with rehabilitation in treatment of cricopharyngeal achalasia in stroke patients

Objective To evaluate the efficacy of catheter bal oon dilatation therapy with rehabilitation in treatment of cricopharyngeal achalasia in stroke patients. Methods Twenty patients with dysphagia caused by stroke were diagnosed as cricopharyngeal achalasia by videofluoroscopic swal owing study（VFSS）. A 12# urethral catheter was inserted into the esophagus and the cricopharygeus muscle was dilated by the water- inflated bal oon of the urethral catheter. The patients were also trained with Mendelsohn or Shaker methods for swal owing relabilitation. The swal owing function was evaluated before and after treat-ment. Results There were 15 cases cured and 5 cases had clinical effectiveness after treatment. The grades of water drinking test after training were significantly lower than those before training and the grades of dysphagia test were significantly higher af-ter training. The time of bolus passing the pharynx was shortened from 0.28s to 0.16s after treatment （al P〈0.01）. Conclusion Bal oon dilatation therapy combined with the Mendelsohn and other methods for rehabilitation is effective in al eviating dysphagia caused by cricopharyngeal achalasia in stroke patients.