戴萌,王杰,卫小梅,等.高分辨率测压评价脑干卒中患者食管期吞咽动力学特征的研究[J].中华物理医学与康复杂志,2020,42(1):13-17
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| 高分辨率测压评价脑干卒中患者食管期吞咽动力学特征的研究 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2020.01.004 |
| 中文关键词: 高分辨率测压 脑干卒中 吞咽功能 食管动力 芝加哥分类 |
| 英文关键词: Manometry Brainstem stroke Swallowing Esophageal motility Chicago classification |
| 基金项目:国家自然科学基金面上项目（81672256）；广东省科技计划基金项目（2016A010105005） |
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| 中文摘要: |
| 目的 运用高分辨率食管固态测压（HRM）技术评价脑干卒中患者食管期的吞咽动力学特征。 方法 纳入因脑干卒中住院行康复治疗的患者18例及健康受试者10例，2组的年龄、性别、体重及体重指数均无明显差异。所有受试者均接受高分辨率食管测压检查，对UES静息压、UES松弛残余压、UES松弛持续时间、食管下括约肌静息压、完整松弛压、食管远端收缩积分、远段收缩延迟时间以及无效蠕动百分比进行分析，并根据芝加哥标准第3版进行食管动力的诊断。 结果 病例组18例脑干卒中患者中，出现食管动力学异常的比例为77.8%，高于对照组（10.0%），组间差异有统计学意义（χ2=11.873，P=0.001）。病例组患者的食管期吞咽动力学异常表现为无效食管运动、高压收缩食管、胃食管连接部出口梗阻、远端食管痉挛；与对照组相比，病例组患者的食管上括约肌静息压（UESRP）［（45.60±20.00）mmHg］较低，食管上括约肌松弛残余压（UESRRP）［（9.75±9.80）mmHg］、食管下括约肌完整松弛压(IRP) ［（8.57±6.13）mmHg］较高，食管上括约肌开放时间(UESRT) ［（457.22±205.14）ms］较短（P＜0.05），食管下括约肌静息压（LESP）、食管远端收缩积分（DCI）、远端收缩延迟时间（DL）的组间比较，差异均无统计学意义（P＞0.05）。 结论 脑干卒中患者多发食管动力异常，HRM技术可应用于评估脑干卒中患者食管期动力，神经源性吞咽障碍患者的食管期吞咽障碍值得重视。 |
| 英文摘要: |
| Objective To evaluate the motility of the esophagus while swallowing of brainstem stroke survivors. Methods Eighteen patients and 10 healthy subjects were included in the study. There was no significant difference in average age, gender, weight or body mass index between the two groups. All underwent high-resolution esophageal manometry to assess esophageal motility while swallowing, and they were rated using the version 3.0 of the Chicago classification. Results Fourteen of the 18 stroke survivors displayed abnormal esophageal dynamics (77.8%), compared with only 10.0% of the healthy control group, but that difference was not statistically significant. The typical abnormalities were a lack of contraction, high pressure contractile esophagus, gastroesophageal junction outflow obstruction and/or distal esophageal spasm. Compared with the control group, the average resting pressure of the patients′ upper esophageal sphincters (UESs) was significantly lower, while the UES residual pressure and integrated relaxation pressure of their lower esophageal sphincters (LESs) were higher and the average UES relaxation time was significantly shorter. No significant differences were found in the LES resting pressures, distal contractile integrals or the distal latency between the two groups. Conclusions Abnormal esophageal motility is highly prevalent in brainstem stroke survivors and due attention should be paid to it. High-resolution manometry can be used to assess this condition. |
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