Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke
<p><strong>Objective</strong> To investigate the mechanism and effect of columnar balloon dilatation therapy on treating patients with severe dysphagia caused by upper esophageal sphincter (UES) achalasia after stroke.<strong> Methods</strong> Sixty -four patients wit...
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| Format: | Article |
| Language: | English |
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Tianjin Huanhu Hospital
2017-03-01
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| Series: | Chinese Journal of Contemporary Neurology and Neurosurgery |
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| Online Access: | http://www.cjcnn.org/index.php/cjcnn/article/view/1561 |
| _version_ | 1818313892116299776 |
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| author | Wei-bo SHAO Yao WANG Wei-wei JIANG Li TIAN Jie ZHANG |
| author_facet | Wei-bo SHAO Yao WANG Wei-wei JIANG Li TIAN Jie ZHANG |
| author_sort | Wei-bo SHAO |
| collection | DOAJ |
| description | <p><strong>Objective</strong> To investigate the mechanism and effect of columnar balloon dilatation therapy on treating patients with severe dysphagia caused by upper esophageal sphincter (UES) achalasia after stroke.<strong> Methods</strong> Sixty -four patients with severe dysphagia caused by UES achalasia after stroke were diagnosed through Video Fluoroscopic Swallowing Study (VFSS) and esophageal dynamics testing. The patients were randomly divided into control group (N = 32) and treatment group (N = 32). Patients in control group were treated with routine drug treatment and routine rehabilitation training, while patients in treatment group were treated with columnar balloon dilatation therapy on the basis of routine treatment. The treatment end point was either the patient resuming an oral diet or after 4-weeks treatment. All cases were evaluated by swallowing function of VFSS, high resolution manometry (HRM) and scores of the severity of dysphagia before treatment and at treatment end point. <strong>Results</strong> Compared with before treatment, UES resting pressure (<em>P</em> = 0.000) and residual pressure (<em>P</em> = 0.000) were significantly decreased, peak pressure was significantly increased (<em>P</em> = 0.000), duration of relaxation was prolonged (<em>P</em> = 0.000), and scores of the severity of dysphagia were significantly increased (<em>P</em> = 0.000, 0.000) in both groups after treatment. Compared with control group, UES resting pressure (<em>P </em>= 0.001) and residual pressure (<em>P</em> = 0.000) were significantly decreased, peak pressure was significantly increased (<em>P </em>= 0.002), duration of relaxation was prolonged (<em>P</em> = 0.000), and scores of the severity of dysphagia were significantly increased (<em>P</em> = 0.000) in treatment group after treatment. Until the treatment end point or after 4-week treatment, the total effective rate in treatment group was significantly higher than that in control group [93.75% (30/32) vs. 81.25% (26/32); <em>χ<sup>2</sup></em> = 4.010, <em>P</em> = 0.000]. <strong>Conclusions</strong> Columnar balloon dilatation therapy is effective for reducing the tension of upper esophageal sphincter and relieving spasm after stroke. It has obvious therapeutic effect on the upper esophageal sphincter achalasia.</p><p> </p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2017.03.005 |
| first_indexed | 2024-12-13T08:40:58Z |
| format | Article |
| id | doaj.art-90d5bfa5c8d746ccbdae481be5372d9c |
| institution | Directory Open Access Journal |
| issn | 1672-6731 |
| language | English |
| last_indexed | 2024-12-13T08:40:58Z |
| publishDate | 2017-03-01 |
| publisher | Tianjin Huanhu Hospital |
| record_format | Article |
| series | Chinese Journal of Contemporary Neurology and Neurosurgery |
| spelling | doaj.art-90d5bfa5c8d746ccbdae481be5372d9c2022-12-21T23:53:32ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312017-03-011731851911530Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after strokeWei-bo SHAO0Yao WANG1Wei-wei JIANG2Li TIAN3Jie ZHANG4Department of Rehabilitation Medicine, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Rehabilitation Medicine, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Medical Imaging, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Rehabilitation Medicine, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Rehabilitation Medicine, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, Jiangsu, China<p><strong>Objective</strong> To investigate the mechanism and effect of columnar balloon dilatation therapy on treating patients with severe dysphagia caused by upper esophageal sphincter (UES) achalasia after stroke.<strong> Methods</strong> Sixty -four patients with severe dysphagia caused by UES achalasia after stroke were diagnosed through Video Fluoroscopic Swallowing Study (VFSS) and esophageal dynamics testing. The patients were randomly divided into control group (N = 32) and treatment group (N = 32). Patients in control group were treated with routine drug treatment and routine rehabilitation training, while patients in treatment group were treated with columnar balloon dilatation therapy on the basis of routine treatment. The treatment end point was either the patient resuming an oral diet or after 4-weeks treatment. All cases were evaluated by swallowing function of VFSS, high resolution manometry (HRM) and scores of the severity of dysphagia before treatment and at treatment end point. <strong>Results</strong> Compared with before treatment, UES resting pressure (<em>P</em> = 0.000) and residual pressure (<em>P</em> = 0.000) were significantly decreased, peak pressure was significantly increased (<em>P</em> = 0.000), duration of relaxation was prolonged (<em>P</em> = 0.000), and scores of the severity of dysphagia were significantly increased (<em>P</em> = 0.000, 0.000) in both groups after treatment. Compared with control group, UES resting pressure (<em>P </em>= 0.001) and residual pressure (<em>P</em> = 0.000) were significantly decreased, peak pressure was significantly increased (<em>P </em>= 0.002), duration of relaxation was prolonged (<em>P</em> = 0.000), and scores of the severity of dysphagia were significantly increased (<em>P</em> = 0.000) in treatment group after treatment. Until the treatment end point or after 4-week treatment, the total effective rate in treatment group was significantly higher than that in control group [93.75% (30/32) vs. 81.25% (26/32); <em>χ<sup>2</sup></em> = 4.010, <em>P</em> = 0.000]. <strong>Conclusions</strong> Columnar balloon dilatation therapy is effective for reducing the tension of upper esophageal sphincter and relieving spasm after stroke. It has obvious therapeutic effect on the upper esophageal sphincter achalasia.</p><p> </p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2017.03.005http://www.cjcnn.org/index.php/cjcnn/article/view/1561StrokeEsophageal achalasiaEsophageal sphincter, upperDeglutition disordersBalloon dilatationRehabilitation |
| spellingShingle | Wei-bo SHAO Yao WANG Wei-wei JIANG Li TIAN Jie ZHANG Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke Chinese Journal of Contemporary Neurology and Neurosurgery Stroke Esophageal achalasia Esophageal sphincter, upper Deglutition disorders Balloon dilatation Rehabilitation |
| title | Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke |
| title_full | Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke |
| title_fullStr | Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke |
| title_full_unstemmed | Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke |
| title_short | Clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke |
| title_sort | clinical study of columnar balloon dilatation therapy for severe dysphagia caused by upper esophageal sphincter achalasia after stroke |
| topic | Stroke Esophageal achalasia Esophageal sphincter, upper Deglutition disorders Balloon dilatation Rehabilitation |
| url | http://www.cjcnn.org/index.php/cjcnn/article/view/1561 |
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