延髓性麻痹患者食管上括约肌群失弛缓范围的回顾性研究  

Retrospective study on the achalasia range of the upper esophageal sphincter in patients with bulbar paralysis

作　　者：石润琇 魏慧[1] 怀娟[1] 侯莹 关家文[3] 岳寿伟[1] SHI Runxiu;WEI Hui;HUAI Juan

机构地区：[1]山东大学齐鲁医院康复医学科,山东省济南市250012 [2]南京医科大学附属苏州医院康复科 [3]武警山东总队医院脊柱外科

出　　处：《中国康复医学杂志》2021年第7期799-803,共5页Chinese Journal of Rehabilitation Medicine

基　　金：山东省重点研发计划(重大研发创新工程)项目(2019JZZY011112)。

摘　　要：目的:通过X线与CT造影剂球囊定位,观察延髓性麻痹患者食管上括约肌群失弛缓范围,为临床肉毒毒素注射的定位提供依据。方法:选取2016年9月—2019年5月期间收治的延髓性麻痹患者共48例,进行回顾性分析,其中27例患者行X线造影剂球囊定位,21例患者行CT造影剂球囊定位,观察球囊上缘与椎体的对应关系,测量造影剂球囊上缘至C6椎体下缘的距离,探讨食管上括约肌群失弛缓范围与年龄的相关性分析。结果:X线球囊上缘至C6椎体下缘距离为(19.05±12.14)mm,CT球囊上缘至C6椎体下缘距离为(18.97±12.07)mm,两组间无显著性差异(P>0.05)。48例患者球囊上缘至C6椎体下缘平均距离(19.01±11.98)mm,球囊上缘多位于C7—T1椎体。相关性分析发现,48例患者年龄与C6椎体下缘至球囊上缘距离存在相关性(r=0.39,P<0.01),病程与C6椎体下缘—球囊上缘两组数据间不存在相关性(r=0.22,P>0.05)。结论:延髓性麻痹患者食管狭窄范围符合食管上括约肌群解剖位置,食管上括约肌群可作为肉毒毒素注射治疗的靶点。食管上括约肌群失弛缓范围与年龄相关,与病程不相关。Objective:To observe the achalasia range of the upper esophageal sphincter in patients with bulbar paralysis through X-ray or CT contrast-enhanced balloon localization,so as to support clinical localization for botulinum toxin injection.Method:A retrospective analysis was conducted on a total of 48 patients with bulbar paralysis treated between September 2016 and May 2019,including 27 performed X-ray contrast-enhanced balloon localization and 21 performed CT contrast-enhanced balloon localization.The correspondence between the superior margin of balloon and the vertebral body was observed,and the distance between the contrast-enhanced superior margin of balloon and the inferior margin of C6 vertebral body was measured,so as to investigate the correlation between age and achalasia range of the upper esophageal sphincter.Result:The distance between the contrast-enhanced superior margin of balloon and the inferior margin of C6 vertebral body measured by X-ray was(19.05±12.14)mm,and by CT was(18.97±12.07)mm.There was no significant difference between the two groups(P>0.05).The average measured value of the 48 patients was(19.01±11.98)mm,and mostly,the superior margin of balloon was located at the C7-T1 vertebral body.A correlation analysis showed that for the 48 patients,age was correlated with the distance(r=0.39,P<0.01)while course of disease was not for both groups(r=0.22,P>0.05).Conclusion:The esophageal stenosis range in patients with bulbar paralysis is consistent with the anatomical position of the upper esophageal sphincter,and so,the upper esophageal sphincter can be used as the target for botulinum toxin injection.The achalasia range of the upper esophageal sphincter is correlated with age,but not correlated with the course of disease.

关 键 词：延髓性麻痹 球囊定位 食管上括约肌 相关性分析 

分 类 号：R493[医药卫生—康复医学]