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摘要
Objective: To investigate the effect of sEMG-BFB combined with routine swallow training in the treatment of dysphagic patients caused by cricopharyngeal stenosis after radiotherapy for nasopharyngeal carcinoma. Method: Sixty dysphagic patients caused by upper UES stenosis after radiotherapy for nasopharyngeal carcinoma were recruited. They were randomly divided into observation group and control group, including 15 patients with incomplete opening of UES sphincter and 15 patients with failure of UES relaxation in each group. Both of them were given routine training including orofacial function training, sensory irritation, and dieting mode proposal, while the observation group was given behavioral swallowing training conducted by the guidance of sEMG-BFB and the control group were treated with active balloon dilataion therapy respectively. Before and after 4 weeks treatment, videofluoroscopy swallowing study(VFSS) was performed to observe the opening of UES. PAS and FOIS were used to evaluate swallow function. Result: Before treatment, there were no significant difference between the two groups in terms of UES opening, PAS score and the FOIS score (P>0.05). ①Comparison of the rate of the UES opening: the UES opening of both group were improved after treatment (P<0.05). There were no significant difference between the two groups in patients with the incomplete opening of UES, while the control group was superior to the treatment group in patients with failure of UES relaxation. ②Comparison of the PAS scores: compared with before treatment, there was significant difference in the PAS score after treatment in each group [3.5(3, 4)vs.3(2, 3), 3.5(3, 4) vs.2(2, 2)], (Z=- 2.293, - 4.014 respectively, all P<0.05). The PAS score of observation groups was significantly higher than that of control group(Z=-2.302, P=0.021). ③Comparison of the FOIS score: compared with treatment before, there was significant difference in the FOIS score after treatment in each group [4(3, 4)vs.5(4, 5), 3 (3, 4) vs. 5(4, 5)] (Z=-2.530, -3.029 respectively, all P<0.05). There was no significant difference in FOIS score between the two groups after treatment (4.63±1.56 vs 4.73±1.48), (Z=-0.143, P>0.886). Conclusion: The dysphagic patients with incomplete opening of UES after radiotherapy for nasopharyngeal carcinoma could be treated effectively by the way of sEMG-BFB. There is no difference of curative effect between the treatment of sEMG-BFB group and active balloon dilataion therapy group.
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