Biomechanic Changes in Pharynx and Upper Esophageal Sphincter after Balloon Dilatation in Brainstem

来源 :第四届粤港澳台物理医学与康复学学术会议暨2013年广东省医学会物理医学与康复学学术会议 | 被引量 : 0次 | 上传用户:cqxiaoguai1986
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  Objective Using high-resolution solid-state manometry,we examined biomechanic changes of physiologic swallowing events in patients with dysphagia after brainstem stroke.Method Thirty brainstem stroke patients with pharyngeal stage dysphagia were involved in this study.15 of them as dilatation treatment group completed 3 weeks of modified balloon dilatation treatment and traditional swallowing therapy.Another 15 patients as control group only completed 3 weeks of traditional swallowing therapy.Before,and following the dilatation we measured FOIS(Functional Oral Intake Scale),pharyngeal manometric pressures peak and duration,the nadir of UES and its duration during swallows of thin liquid,thick liquid,and pasty material in 3 ml volumes.We compared these results to identical measures obtained from control group.Results Brainstem stroke patients with dysphagia always manifest failed UES relaxation and poor pharyngeal propulsion,with decreased UES resting pressure.Following dilatation treatment,12 of 15 patients were removed feeding tube in dilatation group.Post-dilatation the relaxation of UES and propulsion of pharynx were both significantly better than Pre-dilatation in the group of dilatation treatment for three materials (p<0.05).UES resting pressure approximated to normal.Only 2 of 15 patients were removed feeding tube in control group following traditional swallowing therapy.Post-treatment the relaxation of UES in control group was not shown any significantly difference from pre-treatment (p>0.05) for all three materials.Implications Dysphagia therapy with dilatation improves relaxation of UES and propulsion of pharynx during swallowing.Moreover,it is helpful for restoring UES resting pressure.
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