吞咽造影在鼻咽癌放疗后吞咽障碍的应用价值  

Clinical Value Of Videofluoroscopic Swallowing Study In Patients With Nasopharyngeal Carcinoma After Radiotherapy

作　　者：冯红梅[1] 洪居陆[1] 何耀强[1] 高明勇[1] 朱彬[1] 杨冠英[1] Feng Hongmei Hong Julu He Yaoqiang Gao Mingyong Zhu Bin Yangguanying(Department of radiology, the first People＇ s hospital of Foshan, Foshan, Guangdong Province 52800)

机构地区：[1]佛山市第一人民医院影像科,广东佛山528000

出　　处：《现代医用影像学》2016年第6期1084-1088,共5页Modern Medical Imageology

基　　金：2015年佛山市医学科研基金项目(立项编号:2015063)

摘　　要：目的:对不同浓度吞咽物的吞咽X线荧光透视检查(VFSS)分析,探讨VFSS对鼻咽癌(NPC)放疗后吞咽障碍的临床评价价值。材料与方法:米粉与碘佛醇按一定比例调配成2种浓度的对比剂-食团(1:3,A组)和(1:5,B组),并与碘佛醇(对照组,C组)对照。40例NPC放疗后吞咽困难患者行VFSS,观察指标包括吞咽物潴留位置、环咽肌功能、舌及会厌运动情况、渗透及误吸。结果:舌运动障碍出现概率17.5%(7/40),会厌运动障碍出现概率72.5%(29/40),两者差别(X^2=24.444,p=0.000)有统计学意义。3组吞咽物在口腔潴留、环咽肌功能异常、渗透及隐性误吸等差别无统计学意义。吞咽物在梨状窝及会厌谿潴留、误吸等差别有统计学意义,组间两两比较,C组与A组及B组差别均有统计学意义。结论:VFSS有利于临床指导NPC患者吞咽障碍康复训练,减少误吸出现概率。Purpose： The videofluoroscopic swallowing study （VFSS） of different concentrations of swallowing were analyzed, and investigated the clinical value for the patients with nasopharyngeal carcinoma （NPC） after radiotherapy. Materials and Methods： The concentrations of （1 ： 3, group A） and （1 ： 5, group B） were prepared by using rice flour and ioversol, and compared with the ioversol （the control group, group C ）. 40 cases of patients with nasopharyngeal carcinoma （NPC） after radiotherapy were underwent VFSS with the swallowing materials of these three groups. The observation indexes included swallowing things retention position, crieopharyngeal muscle function, tongue and epiglottis movement, permeation and aspiration. Results： The occurrence probability of Tongue dyskinesia and epiglottis moving obstacles was respective 17. 5% （7/40） and 72. 5% （29/40） , these was statistically significant difference（X^2 =24. 444, p =0. 000）. There wert not significant difference between the 3 groups including the oral retention, the functional abnormality of the pharyngeal muscle, the permeation and the occult aspiration. However, the difference were statistically significant about the pyriform sinus retention, swallow valleeular retention and the occult aspiration. With further analysis of these indexes, we found that the group C were statistically significant difference compared with the group A and the group B. Conclusion： VFSS is beneficial to the clinical guidance of NPC patients with dysphagia rehabilitation training and to reduce the probability of aspiration.

关 键 词：鼻咽癌 放射治疗 吞咽障碍 X射线造影 

分 类 号：R739.63[医药卫生—肿瘤] R730.44[医药卫生—临床医学]