Effects Of Stellate Ganglion Block Combined With Comprehensive Rehabilitation In Post-stroke Pharyngeal Dysphagic Patients

BackgroundStroke is a medical condition in which poor blood flow to the brain results in cell death.And stroke accounted for the largest proportion of total disability adjusted life-years(47.3%)and deaths(67.3%)among all neurological disorders.They result in part of the brain not functioning properly.Signs and symptoms of a stroke may include an inability to move or feel on one side of the body,,dysfunction in swallowing,loss of vision to one side,problems in understanding or speaking,or feeling like the world is spinning.Dysphagia is a frequent and potentially serious complication of stroke,and in some cases may be the sole or overriding symptom.According to the World Gastroenterology Organization,42 – 67% of patients present with dysphagia within 3 days of stroke.Post-stroke dysphagia is characterized by difficulty in safely moving food or liquids from the mouth to the stomach without aspiration in patients who suffered stroke.Pharyngeal dysphagia secondary to stroke is the patients,who suffered with stroke,cannot safely delivery food though pharyngeal.It may cause difficulty initiating a swallow,repetitive swallowing,nasal regurgitation,coughing,hoarse voice or aspiration.Post-stroke dysphagia can lead to severe complications such as aspiration pneumonia,dehydration,and even death.Impaired swallowing can aggravate the anxiety and fear of patients,especially those who can not be ingested by mouth,there will show malnutrition,depression,autism or other symptoms.Dysphagia is a frequent and potentially serious complication of stroke,and in some cases may be the sole or overriding symptom.Videofluoroscopic evidence indicates the presence of dysphagia in 64-90% of conscious stroke patients in the acute phase,with aspiration confirmed in 22-42% of cases,it will lead to higher incidence rate of pneumonia and higher mortality rate.However,there is no effective measure for the treatment of pharyngeal dysphagia in stroke patients.In clinical practice,we found that the use of stellate ganglion block,which is based on comprehensive rehabilitation therapy,can improve the swallowing function of dysphagic after stroke.ObjectiveThe aim of this study was to explore the efficacy of stellate ganglion block in post-stroke pharyngeal dysphagic Patients.MethodSixty-five post-stroke patients with pharyngeal dysphagia were randomly allocated to treatment group(n=33)or control group(n=32).Both of two groups were administered to swallow therapy.Meanwhile,patients of treatment group were also undertaken stellate ganglion block.Study patients were assessed at baseline and 20 days after treatment using drinking water test,videofluoroscopic swallowing study and Rosenbek penetration-aspiration scale.ResultsFunctional outcome were significant different in both of groups from baseline to 20 days,whereas the scores of drinking water test,videofluoroscopic swallowing study and Rosenbek penetration-aspiration scale showed differences between two groups after treatment:the treatment group scores in videofluoroscopic swallowing study are greater than control group,but the scores in drinking water test and Rosenbek penetration-aspiration scale are lower than control group.ConclusionsStellate Ganglion Block could improve the swallow function and reduce aspiration in post-stroke pharyngeal dysphagic patients.