| Objective: Based on videofluoroscopic swallowing study to observation,analysis and evaluation the balloon dilatation with acupoint massage treatment of dysphagia in stroke patients with cricopharyngeal dysfunctionstroke clinical curative effect.Further understand the mechanism of balloon dilatation combined acupoint massage treatment cricopharyngeal muscle acalasia after stroke patients,so as to find a kind of new treatment about Chinese and western medicine,which is more effective for swallowing disorder in stroke patients with cricopharyngeal muscle dysfunction.Methods: Subjects were randomly divided into 31 patients in conventional rehabilitation group,31 patients in balloon dilation group and 31 patients in combined treatment group(30 patients in conventional rehabilitation group,28 patients in balloon dilation group and 30 patients in combined treatment group).The conventional rehabilitation group is the routine swallowing rehabilitation training,the balloon dilation group is the routine swallowing rehabilitation training combined with balloon dilation,and the combined treatment group is the conventional swallowing rehabilitation training combined with balloon dilation and acupressure therapy.After 4weeks of treatment in all three groups,swallowing function was evaluated and compared before and after treatment in the three groups.Results:(1)General data:There was no statistically significant difference in the general data analysis such as gender,age,disease course,stroke type and type of relaxasia of cricopharyngeal muscle(P >0.05),indicating that the three groups were comparable.(2)Comparison of total effective rate: the total effective rate in the conventional rehabilitation group was 53.33%,78.57% in the balloon dilation group,and 93.33% in the combined treatment group.In pairwise comparison between groups,the total effective rate of the balloon dilation group was higher than the conventional rehabilitation group(P<0.05),and the combined treatment group was higher than the conventional rehabilitation and balloon dilation group(P<0.05).It shows that the efficacy of the balloon dilatation group was better than the conventional rehabilitation group,and the combined treatment group was better than the conventional rehabilitation group and the balloon dilatation group.(3)All scales and scores: The VFSS score and he water swallowing test after treatment were significantly different than before treatment(P<0.05);after treatment,the VFSS score and t were significantly change from the conventional rehabilitation group(P<0.05),and the VFSS score and the water swallowing test were significantly different compared with the conventional rehabilitation and balloon dilatation group(P<0.05).(4)The mobility of hyoid laryngeal-complex: the mobility of hyoid laryngeal complex in three groups after treatment was significantly improved than that before treatment(P<0.05);After treatment,the hyoid bone,hyoid bone,thyroid cartilage and thyroid cartilage in the balloon expansion group were not significantly improved than those in the conventional rehabilitation group(P>0.05);In the combined treatment group,hyoid bone moved up,hyoid bone moved forward,thyroid cartilage moved up,and thyroid cartilage moved forward were significantly increased than those in the conventional rehabilitation group(P<0.05),and hyoid bone moved up,hyoid bone moved forward and thyroid cartilage movde up were significantly higher than those in balloon dilation group(P < 0.05),but thyroid cartilage moved forward is not(P>0.05).(5)Upper esophageal sphincter openness: the openness of the upper esophageal sphincter was significantly improved after treatment(P<0.05);after treatment,the upper esophageal sphincter openness in the balloon dilatation group was significantly improved compared with the conventional rehabilitation group(P<0.05),and the upper esophageal sphincter openness was significantly improved compared with the conventional rehabilitation and balloon dilatation group(P<0.05).Conclusion(s): Videofluoroscopic swallowing study that can accurately evaluate the changes of swallowing function in patients with cycloopharmuscle acalasia after stroke.Acupressure massage combined with balloon dilatation and conventional swallowing rehabilitation training can effectively reduce the water swallowing test also can improve the VFSS score,the mobility of hyoid laryngeal-complex and the openness of upper esophageal sphincter in swallowing disorder in stroke patients with cricopharyngeal muscle dysfunction,and improve their swallowing function.Its efficacy is better than simple swallowing rehabilitation training or simple swallowing rehabilitation combined with balloon dilatation. |
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