Jo Yong Seob, Cha Jung Hyun, Kim Yong Kyun, Kim Sun Young, Lee Hong Sub
Department of Physical Medicine and Rehabilitation, Myongji Hospital.
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang.
Medicine (Baltimore). 2020 Aug 28;99(35):e21793. doi: 10.1097/MD.0000000000021793.
The role of endoscopic balloon dilatation (EBD) using double-balloon catheters in patients with cricopharyngeal muscle dysfunction (CPD) is still unclear. Thus, the aim of this study was to compare the functional outcomes between patients receiving EBD and rehabilitative balloon swallowing (RBS).A total of 36 patients with CPD, who visited a teaching hospital from February 2014 to June 2017, were included in the study. Among them, 12 patients with severe dysphagia underwent EBD. After propensity score matching, 24 patients who underwent RBS were selected for comparison. We compared the effects of EBD and RBS using 4 functional swallowing parameters: functional dysphagia scale score, penetration-aspiration scale score, pharyngeal transit time, and percentage of pharyngeal remnant (PR) at baseline and after the first and second treatments. Using simple and multiple regression, we examined the associations between EBD/RBS and changes of 4 parameters after the treatments since the baselineAll functional parameters significantly decreased after RBS and EBD (P < .05). After the first therapy session, significant differences in the pharyngeal transit time (P = .034), percentage of PR (P = .008), and penetration-aspiration scale score (P = .014) were observed in the EBD group, compared with those in the RBS group. The regression analysis showed significant improvements in the PR after EBD compared with that after RBS (β = 0.95, SE = 0.31, P = .005).EBD may be an alternative treatment for patients with severe CPD. A significant improvement would be expected in such patients with PR.
使用双球囊导管进行内镜下球囊扩张术(EBD)在环咽肌功能障碍(CPD)患者中的作用仍不明确。因此,本研究的目的是比较接受EBD和康复性球囊吞咽(RBS)患者的功能结局。
共有36例2014年2月至2017年6月在一家教学医院就诊的CPD患者纳入本研究。其中,12例严重吞咽困难患者接受了EBD。经过倾向评分匹配后,选择24例接受RBS的患者进行比较。我们使用4个功能性吞咽参数比较EBD和RBS的效果:功能性吞咽困难量表评分、渗透-误吸量表评分、咽部通过时间以及基线时和首次及第二次治疗后的咽部残留百分比(PR)。使用简单和多元回归分析,我们研究了EBD/RBS与治疗后4个参数自基线起变化之间的关联。
RBS和EBD后所有功能参数均显著降低(P<0.05)。在首次治疗后,EBD组与RBS组相比,咽部通过时间(P=0.034)、PR百分比(P=0.008)和渗透-误吸量表评分(P=0.014)存在显著差异。回归分析显示,与RBS后相比,EBD后PR有显著改善(β=0.95,SE=0.31,P=0.005)。
EBD可能是重度CPD患者的一种替代治疗方法。预计此类PR患者会有显著改善。