电视X线透视吞咽功能检查在声带麻痹患者吞咽困难中应用评估及康复建议  

The study on TNF-α plays role in pathogenesis of hypertension by modulating norepinephrine

作　　者：司世雷 

机构地区：[1]郑州市中医院康复科,450006

出　　处：《实用医学影像杂志》2017年第2期146-148,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨电视X线透视吞咽功能检查(VFSS)在声带麻痹(VCP)患者吞咽困难中的应用价值。方法使用改进的Logemann方法,用稠和稀的液体进行VFSS。根据28例患者的VCP是否是中心或外周来源对患者进行分组,并比较各组的VFSS发现。结果 13例患者中发现口腔异常,在所有患者中发现咽相异常,包括20例患者的穿透异常和14例患者的抽吸异常。在中心VCP患者中,不适当的唇闭合(LC)和推注形成(BF)和触发咽部延迟(TPS)和食管上括约肌释放(UESR)更频繁。与薄液体吞咽,咽中转时间(PTT)和咽延迟时间(PDT)在中央VCP患者中时间更长。结论吞咽的延迟和吞咽协调差对于中枢性VCP患者影响是巨大的。Objective To review the findings of a video fluoroscopic swallowing study （VFSS） of 28 patients with vocal cord paralysis （VCP） who complained of swallowing difficulties. Methods VFSS were performed with thick and thin liquid using modified Loge-Mann methods. The patients were grouped according to whether their VCP was of central or peripheral origin, and the VFSS findings of the groups were compared. Results The patients showed oral phase dysfunction and pharyngeal dysfunction, especially when the cause was of central origin. Oral phase abnormali- ties were found in 13 patients and pharyngeal phase abnormalities were found in all patients, including penetration in 20 patients and aspiration in 14 patients. Improper lip closure （LC） and bolus formation （BF） and a delay in triggering pharyngeal swallow （TPS） and upper esophageal sphincter release （UESR） were significantly more frequent in patients with central VCP. With thin-liquid swallowing, pharyngeal transit time （PTT） and pharyngeal delay time （PDT） were significantly more prolonged in central VCP. Conclusion The results suggest that the delay in triggering and poor coordination of swallowing are profound in patients with central VCP, but dysfunction in peripheral VCP may originate from poor pharyngeal movement.

关 键 词：声带麻痹 电视X线透视 吞咽困难 脱落 

分 类 号：R767.4[医药卫生—耳鼻咽喉科] R816.96[医药卫生—临床医学]