于帆，窦祖林，陈文华，兰月，林拓，卫小梅.吞咽造影同步咽腔测压评估脑干损伤后吞咽障碍[J].中华物理医学与康复杂志,2016,38(1):24-28
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| 吞咽造影同步咽腔测压评估脑干损伤后吞咽障碍 |
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| DOI： |
| 中文关键词: 吞咽障碍 吞咽造影 同步咽腔测压 高分辨率测压 |
| 英文关键词: Dysphagia Swallowing video fluoroscopy Manofluorography High-resolution manometry |
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| 中文摘要: |
| 目的使用吞咽造影同步咽腔测压（MFG）评估脑干损伤后吞咽障碍患者的吞咽功能，分析异常的运动学与生物力学参数以及舌骨位移与咽腔、上食管括约肌（UES）压力之间的关系。 方法对脑干损伤后吞咽障碍患者（病例组）13例与健康志愿者（对照组）13例分别进行MFG检查，对比两组吞咽时的运动学与生物力学参数,分析两组运动学与生物力学参数之间的关系。 结果病例组舌根与下咽部的压力峰值、压力上升速率、舌骨向前位移低于对照组，病例组UES的最大开放幅度、开放后压力峰值、开放持续时间低于对照组。病例组舌根部与下咽部的收缩持续时间、UES松弛残余压高于照组。对照组舌骨向前位移与UES松弛残余压成负相关；病例组舌骨向前位移分别与舌根部压力峰值、下咽部压力峰值成正相关。 结论MFG可以同时使用吞咽造影和高分辨率咽腔测压评估吞咽功能，可作为临床一种精确、全面的定量评估吞咽功能的方法。 |
| 英文摘要: |
| Objective To evaluate the swallowing function of patients with dysphagia after brainstem injury using manofluorography (MFG), analyzing the abnormal biomechanical and kinematic parameters as well as any correlation between changes in the pharynx and the upper esophageal sphincter (UES) measured manometrically and changes in the kinematics of the hyoid bone. MethodsThirteen patients with dysphagia after brainstem injury (the patient group) and 13 healthy participants (the control group) underwent manofluorography. Kinematics and biomechanical changes during swallowing were compared between the two groups and the correlations between the observations were analyzed. Results The patient group showed significantly lower maximum pressure and rate of pressure change at the base of the tongue and in the hypopharynx, as well as less hyoid anterior displacement, smaller and briefer UES opening, but significantly higher minimum pressure at UES relaxation. The duration of tongue root elevation and hypopharynx pressure was also shorter than in the control group, on average. There was a negative correlation between hyoid anterior displacement and the minimum pressure on UES relaxation in the control group, and a positive correlation between hyoid anterior displacement and the maximum pressure at the base of the tongue and in the hypopharynx in the patient group. ConclusionsThe concurrent use of manometry and video-fluorography for evaluating dysphagia can be an objective and effective diagnostic tool for the comprehensive evaluation of swallowing function. |
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