采用电视透视评估重症肌无力患者的吞咽功能  

Videofluoroscopic assessment of swallowing functionin patients with myasthenia gravis

作　　者：Higo R. Nito T. Tayama N. 张玉龙 

机构地区：[1]Department of Otolaryngology,Faculty of Medicine, University of Tokyo, 3-1,Hongo 7-chome, Bunkyo-ku, Tokyo 113-8655, Japan

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第8期48-48,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Swallowing function in myasthenia gravis (MG) was investigated by videofluoros copy (VF). A total of 23 VF examinations were performed on 11 MG patients at var ious time points over the exacerbation and remission stages of disease. The asse ssment parameters on VF examination are set as follows: bolus transport from the mouth to the pharynx, bolus holding in the oral cavity, velopharyngeal seal, to ngue base movement,pharyngeal constriction, laryngeal elevation, upper esophagea lsphincter (UES) opening, and bolus stasis at the pyriform sinus(PS). Aspiration was also assessed on VF examination. Aspiration was seen in 34.8%, and half of these cases involved silent aspiration. Three of four cases that showed silent aspiration went on to experience aspiration pneumonia during the follow-up term . By Spearman’s rank correlation, disturbance of laryngeal elevation was signif icantly correlated with aspiration(p=0.001), and incomplete UES opening was not significantly,but tended to be,correlated with aspiration(p=0.067). Although oth er parameters in the oral and pharyngeal phase on VF examination, such as bolus transport from the oral cavity to the pharynx, pharyngeal constriction, or stasi s at the PS, were remarkably disturbed (in more than 50%of the examinations),th ose parameters were not good indicators for aspiration. When a disturbance of la ryngeal elevation is found at a bedside clinical test, we recommend performing p recise swallowing evaluation,such as VF, Fiberoptic Endoscopic Evaluation of Swa llowing(FEES), and/or scintigraphic assessment of swallowing, for MG patients, t o detect silent aspiration.Swallowing function in myasthenia gravis (MG) was investigated by videofluoros copy (VF). A total of 23 VF examinations were performed on 11 MG patients at var ious time points over the exacerbation and remission stages of disease. The asse ssment parameters on VF examination are set as follows: bolus transport from the mouth to the pharynx, bolus holding in the oral cavity, velopharyngeal seal, to ngue base movement,pharyngeal constriction, laryngeal elevation, upper esophagea lsphincter (UES) opening, and bolus stasis at the pyriform sinus(PS). Aspiration was also assessed on VF examination. Aspiration was seen in 34.8%, and half of these cases involved silent aspiration. Three of four cases that showed silent aspiration went on to experience aspiration pneumonia during the follow-up term . By Spearman's rank correlation, disturbance of laryngeal elevation was signif icantly correlated with aspiration(p=0.001), and incomplete UES opening was not significantly,but tended to be,correlated with aspiration(p=0.067). Although oth er parameters in the oral and pharyngeal phase on VF examination, such as bolus transport from the oral cavity to the pharynx, pharyngeal constriction, or stasi s at the PS, were remarkably disturbed (in more than 50%of the examinations),th ose parameters were not good indicators for aspiration. When a disturbance of la ryngeal elevation is found at a bedside clinical test, we recommend performing p recise swallowing evaluation,such as VF, Fiberoptic Endoscopic Evaluation of Swa llowing(FEES), and/or scintigraphic assessment of swallowing, for MG patients, t o detect silent aspiration.

关 键 词：重症肌无力 吞咽功能 误咽 电视透视 无症状性 梨状隐窝 腭咽闭合 吸入性肺炎 口部 功能障碍 

分 类 号：R746.1[医药卫生—神经病学与精神病学]