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一项随机对照试验研究了神经肌肉电刺激和球囊扩张联合治疗鼻咽癌患者放射性吞咽困难的效果。

A randomized controlled trail of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of radiation-induced dysphagia in nasopharyngeal carcinoma patients.

机构信息

Department of Rehabilitation, The First Affiliated Hospital of GuangXi Medical University, NanNing, China.

出版信息

Disabil Rehabil. 2013 Mar;35(6):450-4. doi: 10.3109/09638288.2012.697250. Epub 2012 Jul 4.

Abstract

Dysphagia is a most common complication induced by radiotherapy in nasopharyngeal carcinoma (NPC) patients. This randomized controlled trail (RCT) was performed to evaluate the therapeutic effect of combination therapy of neuromuscular electrical stimulation (NMES) and balloon dilatation in the treatment of radiation-induced dysphagia in NPC patients. Sixty NPC patients with radiation-induced dysphagia were assigned to either the combination rehabilitation group (treatment group) or the routine rehabilitation group (control group) at random. Both groups were subjected to routine rehabilitation treatment, while the combination rehabilitation group also received combination therapy of NMES and balloon dilatation for 4 months. The water swallow test (WST) and videofluoroscopic swallowing study (VFSS) were used to evaluate the severity of dysphagia. The treatment group showed a significant improvement in swallowing function when compared with the control group. When the WST was used, the efficacy rate (percentage of patients with excellent and effective results) of treatment group was higher than that of control group (90.1 vs. 76.3%), and the difference was statistically significant (χ(2) = 8.55, p = 0.036). When the VFSS was used, the videofluoroscopy results in our study showed that the values of oral transit time (OTT), swallow reaction time (SRT), pharyngeal transit time (PTT) and laryngeal closure duration (LCD) in treatment group were notably improved when compared with those in control group. In conclusion, combination rehabilitation treatment can improve swallow function in the treatment of radiation-induced dysphagia in NPC patients.

摘要

吞咽困难是鼻咽癌(NPC)患者放疗后最常见的并发症。本随机对照试验(RCT)旨在评估神经肌肉电刺激(NMES)联合球囊扩张治疗 NPC 放疗后吞咽困难的疗效。将 60 例 NPC 放疗后吞咽困难患者随机分为联合康复组(治疗组)和常规康复组(对照组)。两组均给予常规康复治疗,联合康复组同时给予 NMES 联合球囊扩张治疗 4 个月。采用饮水试验(WST)和电视透视吞咽造影检查(VFSS)评估吞咽困难严重程度。治疗组吞咽功能较对照组明显改善。WST 时,治疗组有效率(显效+有效例数百分比)高于对照组(90.1%比 76.3%),差异有统计学意义(χ(2) = 8.55,p = 0.036)。VFSS 时,治疗组口腔通过时间(OTT)、吞咽反射时间(SRT)、咽通过时间(PTT)和喉关闭时间(LCD)等录像测量值较对照组明显改善。结论:联合康复治疗可改善 NPC 放疗后吞咽困难患者的吞咽功能。

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