RESUMEN
Objective To investigate the effects of catheter balloon dilatation on patients with dysphagia caused by neurogenic cricopharyngeal achalasia.Methods Thirty-two patients with dysphagia caused by neurogenic cricopharyngeal achalasia were divided randomly into a treatment group (n =16) and a control group (n =16).The treatment group received catheter balloon dilatation therapy and routine dysphagia rehabilitation training; the control group was treated with routine dysphagia rehabilitation training only.Both groups were tested before treatment,after 3 weeks of treatment (after treatment) and at 6 months after treatment (follow-up).All cases were evaluated using Saitoh's 7-grade swallowing assessment and videofluoroscopy.Results After treatment,5 cases in the treatment group had been cured (31％) and 8 cases showed marked effectiveness (50％) ; in the control group,1 case was cured (7％) and 5 cases showed marked effectiveness (31％).These differences were statistically significant.At follow-up,5 cases in the treatment group had been cured (31％) and 9 cases showed marked effectiveness (56％) ; for the control group,1 case was cured (7％) and 6 cased showed marked effectiveness (38％).Those differences were also statistically significant.After treatment and also at follow-up,the average time for a bolus to pass the pharynx in the treatment group was significantly shorter than that in the control group.Conclusion Catheter balloon dilatation therapy is effective for treating neurogenic cricopharyngeal achalasia in both the short and long term.
RESUMEN
Objective To investigate the effect of different intervention times on the efficacy of catheter balloon dilatation therapy for cricopharyngea] achalasia after stroke.Methods Forty-eight cases diagnosed as cricopharyngeal achalasia were divided into 4 groups,groups A,B,C,and D according to the time of intervention from the onset (i.e.0.5,0.5-1,1-3,and 3-6 months),with 12 cases in each group.A 14# urethral catheter was inserted into the esophagus and water was injected into the balloon to make it turgid.The catheter was then pulled upwards through the stricture in the esophagus to dilatate the cricopharygeal muscle.The patients also received low frequency electrical stimulation combined with dysphagia rehabilitation behavioral therapy once daily.The treatment end point was either when the patient resumed an oral diet or after 6 weeks of treatment.The effects of the treatment were evaluated in terms of the number of times the dilatation therapy was administered,the pharyngeal transit duration,swallowing function and fluoroscopic examination before and after treatment.Results Groups A,B and C required significantly fewer treatment sessions than group D.Groups A and B required significantly fewer sessions than group C,but the difference between groups A and B was not statistically significant.After treatment,there were 11 patients can eat water,liquid,paste and solid food both in groups A and B.But the number of patients who can eat the4 traits of food was 9,9,10,9 in group C and 6,6,7,5 in group D respectively.Swallowing function in groups A,B and C was adjudged,on average,significantly better than in group D.Compared with group C,swallowing function in groups A and B was also significantly improved,but the difference between groups A and B was not statistically significant.The pharyngeal transit duration in all 4 groups was shorter than before treatment,but the duration in groups A,B and C was significantly shorter than in group D.Compared with group C,the pharyngeal transit duration in groups A and B was significantly shorter,but the difference between groups A and B was again not statistically significant.Fluoroscopy showed the efficiency in groups A and B to be over 91 ％.In group C it was 83％ and in group D 58％.The difference between group D and groups A,B and C was significant.The efficiency in groups A and B was significantly better than in group C,but the difference between groups A and B again was not statistically significant.Conclusions Early intervention using catheter balloon dilatation therapy can facilitate the improvement of swallowing function in patients with cricopharyngeal achalasia after stroke and improve their quality of life.