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目的探讨改良双腔球囊导管治疗环咽肌失弛缓症患者的可行性及安全性。方法将环咽肌失弛缓症患者50例随机分为试验组和对照组,每组各25例。两组均接受常规治疗,包括药物治疗、吞咽功能训练、摄食训练及辅以VitalStim神经肌肉低频电刺激治疗。试验组采用改良双腔球囊导管进行环咽肌扩张治疗,对照组采用14号普通导尿管进行环咽肌扩张治疗。采用洼田氏饮水试验和吞咽X线电视透视检查(VFSS)对治疗效果进行评估,评估患者黏膜水肿、出血和疼痛等并发症情况。结果治疗后两组洼田氏饮水试验和VFSS评分均明显高于治疗前(P<0.05),两组间差异无统计学意义(P>0.05)。对照组并发症的发生率明显高于试验组(P<0.05)。结论两组治疗均可有效缓解环咽肌失弛缓症,应用改良双腔球囊导管可明显减少并发症的发生。
Objective To investigate the feasibility and safety of modified dual-lumen balloon catheter in the treatment of achalasophanthus in patients with cricopharyngeal muscle. Methods 50 cases of achalasopharyngeal achalasia patients were randomly divided into experimental group and control group, 25 cases in each group. Both groups received routine treatment, including medication, swallowing function training, feeding training and supplemented with VitalStim neuromuscular low-frequency electrical stimulation treatment. The experimental group was treated with improved double-lumen balloon catheter for dilation of the cricopharyngeal muscle. The control group was treated with the general catheter of No. 14 for the dilation of the cricopharyngeal muscle. The Kustian drinking water test and swallowing X-ray fluoroscopy (VFSS) were used to evaluate the therapeutic effect and to evaluate the complications such as mucosal edema, hemorrhage and pain. Results After treatment, the water test and the VFSS score of two groups were significantly higher than those before treatment (P <0.05). There was no significant difference between the two groups (P> 0.05). The incidence of complications in the control group was significantly higher than that in the experimental group (P <0.05). Conclusion Both groups can effectively relieve achalasia of cricopharyngeal muscle. The application of modified dual-lumen balloon catheter can significantly reduce the incidence of complications.