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目的探讨导尿管球囊扩张治疗环咽肌失弛缓症的可行性,客观评价其治疗效果。方法放射性脑病、脑干梗死伴吞咽障碍患者各1例,经吞咽X线荧光透视检查和光纤内窥镜吞咽检查,拟诊环咽肌失弛缓症。利用14号导尿管球囊,采用注水方式使球囊充盈,牵拉导尿管,自下而上缓慢移动球囊,使球囊反复多次通过狭窄的食道入口,逐渐扩张环咽肌。同时在颈部结合Vitalstim神经肌肉低频电刺激,进食指导训练。结果分别给予4次及15次扩张治疗后,2例患者均可独立自主进食糊状食物,无呛咳。吞咽造影复查显示在食团通过时,环咽肌正常开放,误吸消失。结论导尿管球囊扩张术能有效缓解环咽肌失弛缓,操作简单,安全可靠。吞咽动态造影是明确诊断及疗效评价必不可少的检查方法。
Objective To investigate the feasibility of catheter balloon dilatation in the treatment of achalasia of the pharyngeal muscle and objectively evaluate its therapeutic effect. Methods One case of radiation encephalopathy and one case of brainstem infarction with swallowing dysfunction were examined by swallowing X-ray fluoroscopy and optical fiber endoscopy swallowing to diagnose achalasopharyngeal achalasia. The use of 14 catheter balloon, the use of water filling the balloon filling, pulling catheter, slowly moving the balloon from bottom to top, the balloon repeatedly through the narrow esophageal inlet, and gradually expand the cricopharyngeal muscle. At the same time in the neck with Vitalstim neuromuscular low-frequency electrical stimulation, eating guidance training. Results were given 4 times and 15 times after dilation treatment, 2 patients can independently eat mushy food, no cough. Swallowing angiography review showed that the passage of the regiment, the ring pharyngeal muscle normal open, aspiration disappear. Conclusion Catheter balloon dilation can effectively relieve ciliary pharyngeal muscle atrophy, simple operation, safe and reliable. Swallowing dynamic contrast imaging is a clear diagnosis and evaluation of the effects of essential tests.