| 胡婷婷,吴亚岑,龚放华,赵婷,李梅枝.改良冰水循环球囊扩张术在卒中后环咽肌失弛缓症患者咽反射异常中的吞咽康复效果[J].中国康复,2025,40(9):520-524 |
| 改良冰水循环球囊扩张术在卒中后环咽肌失弛缓症患者咽反射异常中的吞咽康复效果 |
| Modified ice-water circulating balloon dilation technology in swallowing rehabilitation for post-stroke cricopharyngeal achalasia patients with abnormal pharyngeal reflex |
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| DOI：10.3870/zgkf.2025.09.002 |
| 中文关键词: 冰水循环 球囊扩张 脑卒中 咽反射 环咽肌失弛缓 吞咽康复 |
| 英文关键词: ice-water circulation balloon dilation stroke pharyngeal reflex cricopharyngeal achalasia swa-llowing rehabilitation |
| 基金项目:湖南省卫生健康委科研计划课题项目（B2019053）；湖南中医药大学校院联合基金项目（2024XYLH214）； 湖南中医药大学课程思政教学案例库建设项目（2024KCSZ29） ；湖南省自然科学基金项目（2025JJ90084）；湖南省卫生健康高层次人才重大科研专项（R2023085） |
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| 中文摘要: |
| 目的：探讨改良冰水循环球囊扩张技术在卒中后环咽肌失弛缓症中的应用效果，尤其是对咽反射异常的改善作用及其对吞咽康复的影响。方法：选取脑卒中后环咽肌失弛缓症并咽反射异常的33例患者，随机分为观察组18例和对照组15例，观察组采用改良冰水循环球囊扩张治疗，对照组采用普通导尿管扩张治疗。2组患者每天治疗1次，每次约30min，每周5次,于干预前、干预满4周或干预后拔除胃管恢复经口进食（治疗未满4周）进行疗效比较，采用咽反射异常程度评分、吞咽障碍程度评分、临床疗效、安全性评价分析比较2组患者咽反射改善情况及吞咽功能的变化。结果：治疗后2组的咽反射评分及吞咽障碍评分均较治疗前明显提高（P＜0.05），且观察组的咽反射评分及吞咽障碍评分显著高于对照组（P＜0.05）；观察组治疗时长显著短于对照组（P＜0.05），观察组吞咽总有效率明显高于对照组（P＜0.05），在治疗过程中，观察组在安全性评价方面均优于对照组（P＜0.05）。结论：改良冰水循环球囊扩张技术，在改善卒中后环咽肌失弛缓症患者的吞咽康复中具有显著优势，能够有效改善咽反射异常，值得在临床中推广。 |
| 英文摘要: |
| Objective: To explore the efficacy of modified ice-water circulating balloon dilation technology in post-stroke cricopharyngeal achalasia patients, particularly its improvement effects on abnormal pharyngeal reflex and swallowing rehabilitation. Methods: Thirty-three stroke patients with cricopharyngeal achalasia and abnormal pharyngeal reflexes were randomly assigned to either modified ice-water cyclic balloon dilation group(n=18) or conventional catheter dilation group(n=15). Both groups received daily 30-min sessions (5 days/week). Outcomes were assessed before and after 4 weeks of treatment (or earlier if oral feeding resumed), including pharyngeal reflex recovery, dysphagia improvement (clinical efficacy scores), and safety (pain, mucosal bleeding, laryngeal edema). Differences between groups were statistically compared. Results: The observation group achieved a 100% effective rate in swallowing recovery post-treatment, compared to 93.33% in the control group, with comparable differences between groups. The observation group demonstrated statistically significant superiority in treatment duration (P<0.05) and post-treatment pharyngeal reflex scores (P<0.05). Both groups showed marked improvement in clinical efficacy scores for dysphagia (P<0.05), and the final score of clinical efficacy of swallowing disorder in the obser-vation group was significantly higher than that in the control group (P<0.05). Notably, the observation group exhibited lower incidence of pain, laryngeal edema, and mucosal bleeding than the control group (P<0.05), indicating enhanced safety. Conclusion: The modified ice-water circulating balloon dilation technology exhibits significant advantages in improving swallowing rehabilitation for post-stroke cricopharyngeal achalasia patients, effectively ameliorating abnormal pharyngeal reflex. It warrants clinical promotion. |
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