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肌萎缩侧索硬化症(ALS)患者经皮扩张气管切开术(PDT)及辅助治疗后嗓音功能的保留

Preservation of Vocal Function in Amyotrophic Lateral Sclerosis (ALS) Patients Following Percutaneous Dilatational Tracheostomy (PDT) and Adjuvant Therapies.

作者信息

Yoo Jae-Kook, Kwon Soon-Hee, Yoon Sul-Hee, Lee Jeong-Eun, Jeon Jong-Eun, Chung Je-Hyuk, Lee Sang-Yoon

机构信息

Department of Neurolgy, The Rodem Hospital, Incheon 22142, Republic of Korea.

Department of Internal Medicine, The Rodem Hospital, Incheon 22142, Republic of Korea.

出版信息

Biomedicines. 2024 Aug 2;12(8):1734. doi: 10.3390/biomedicines12081734.

Abstract

UNLABELLED

The study aimed to evaluate the efficacy of percutaneous dilatational tracheostomy (PDT) combined with adjuvant therapies in preserving vocal function in amyotrophic lateral sclerosis (ALS) patients.

METHODS

We performed a retrospective analysis of 47 ALS patients who underwent PDT at the Rodem Hospital from 2021 to 2023. Post-operatively, these patients were provided with a comprehensive treatment plan that included regenerative injection therapy, low-frequency electrical stimulation, respiratory rehabilitation, and swallowing rehabilitation therapy. Additionally, a balloon reduction program was implemented for effective tracheostomy tube (T-tube) management. The preservation of vocal functions was evaluated 4 weeks following the procedure.

RESULTS

While some patients maintained or slightly improved their ALSFRS-R speech scores, the overall trend indicated a decrease in speech scores post-PDT. This suggests that PDT in combination with adjuvant therapies may not universally improve vocal function, but can help maintain it in certain cases.

CONCLUSIONS

Our findings indicate that PDT combined with mesotherapy, low-frequency electrical stimulation, and swallowing rehabilitation therapy may play a role in maintaining vocal function in limb type ALS patients, though further research is needed to optimize patient management and to validate these results.

摘要

未标注

本研究旨在评估经皮扩张气管切开术(PDT)联合辅助治疗对肌萎缩侧索硬化症(ALS)患者声带功能的保护效果。

方法

我们对2021年至2023年在罗德姆医院接受PDT的47例ALS患者进行了回顾性分析。术后,为这些患者提供了一个综合治疗方案,包括再生注射治疗、低频电刺激、呼吸康复和吞咽康复治疗。此外,实施了一个气囊减压计划以有效管理气管切开管(T管)。在手术后4周评估声带功能的保留情况。

结果

虽然一些患者的ALSFRS-R言语评分保持不变或略有改善,但总体趋势表明PDT后言语评分下降。这表明PDT联合辅助治疗可能不会普遍改善声带功能,但在某些情况下可以帮助维持声带功能。

结论

我们的研究结果表明,PDT联合中胚层疗法、低频电刺激和吞咽康复治疗可能在维持肢体型ALS患者的声带功能方面发挥作用,不过需要进一步研究以优化患者管理并验证这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9b8/11352188/25b100a1ddc5/biomedicines-12-01734-g001.jpg

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