吞咽障碍患者环咽肌的精准解剖学定位  

Anatomical Location of Cricopharyngeus in Patients with Swallowing Disorder

作　　者：葛微微 杨扬 王孝文 GE Wei-wei;YANG Yang;WANG Xiao-wen(Department of Rehabilitation,Weifang Medical University,Weifang,Shandong 261000,China)

机构地区：[1]潍坊医学院康复医学院,山东潍坊市261000

出　　处：《中国康复理论与实践》2021年第3期297-301,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：潍坊医学院教研课题实践教学改革与研究专项(No.2019ZXSJ001);山东省大学生创新创业训练计划项目(No.S201910438021S);潍坊医学院大学生科技创新基金项目(No.KX2019058)。

摘　　要：目的进一步明确环咽肌在人体的定位。方法2018年9月至2019年12月,对19例吞咽障碍患者行透视荧光吞咽检查(VFSS)并保存视频,采用Uniweb 4.0软件对视频行环咽肌相对位置测量。建立成人颈部结构水模型,还原真人吞咽功能检查场景,得到实际测量值与计算机测量值的缩放比例,获得相对精确环咽肌实际位置。对6例成人标本进行解剖,以拟治疗平面与环咽肌长轴的交点为原点,以水平轴为X轴,矢状轴为Y轴,精确定位环咽肌。结果VFSS示环咽肌位于C6椎附近;水模型测量值与计算机测量值的缩放比例约为1∶1.340。拟治疗平面为平C6椎体上缘;在甲状腺外侧缘,皮肤表面距环咽肌(33.47±2.21)mm,与矢状面夹角(43.37±1.34)°;在颈内静脉内侧缘,皮肤表面距环咽肌(34.59±1.29)mm,与矢状面夹角(46.32±0.93)°。结论获得环咽肌较精准的位置信息,可为临床环咽肌功能障碍的康复提供参考。Objective To further clarify the location of cricopharyngeus in human body.Methods From September,2018 to December,2019,19 inpatients with swallowing disorders received video fluoroscopic swallowing study(VFSS).The videoes were used to measure the position of cricopharyngeus with Uniweb 4.0 software.Water model simulating the structure of an adult's neck was established to restore the real measurement scene,and obtain the scale ratio between the actual measurement and the computer measurement,then obtain the accurate actual position of the cricopharyngeus.Six adult specimens were dissected.The intersection point of the intended treatment plane and the long axis of cricopharyngeus was taken as the origin,the horizontal axis as X axis,and the sagittal axis as Y axis,to locate the position of cricopharyngeus precisely.Results Cricopharyngeus was closest to the sixth cervical vertebra.The scaling ratio of the actual measurement obtained from the water model to the computer measurement was about 1∶1.340.The intended treatment plane was closest to the upper edge of the sixth cervical vertebra;on lateral edge of thyroid,cricopharyngeus was(33.47±2.21)mm deep to epidermis,with the angle of(43.37±1.34)°to sagittal axis;and it was(34.59±1.29)mm and(46.32±0.93)°on medial edge of internal jugular vein.Conclusion The the accurate location of cricopharyngeus in human body has been measured,which can help for the rehabilitation for cricopharyngeal dysfunction.

关 键 词：环咽肌 透视荧光吞咽检查 解剖定位 

分 类 号：R743.3[医药卫生—神经病学与精神病学]