VFSS咽期异常表现与误吸的相关性分析  

Correlation analysis of aspiration and abnormal pharyngeal manifestations of VFSS

作　　者：郭雅柔 杜丽洁[2] 郭玲彤 GUO Ya-rou;DU Li-jie;GUO Ling-tong(Department of Medical Imaging,Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学医学影像学院,太原030001 [2]山西医科大学第一临床医院放射科,太原030001

出　　处：《放射学实践》2023年第2期162-166,共5页Radiologic Practice

摘　　要：目的:基于吞咽X线荧光透视造影检查(VFSS)分析咽期异常表现与误吸的关系,旨在为临床治疗提供依据。方法:回顾性分析261例吞咽功能紊乱患者的VFSS动态录像,记录每例患者有无误吸以及吞咽反射启动延迟、喉上抬速度减慢和幅度不足、环咽肌开放不良、软腭与咽后壁之间闭合不良、梨状窝对比剂滞留和会厌谿对比剂滞留这7项咽期异常表现。将上述7个征象纳入多因素logistic回归分析,探讨各征象与误吸的相关性。结果:Logistic回归分析显示吞咽反射启动延迟(OR=6.666,P<0.05)、喉上抬幅度不足(OR=3.682,P<0.05)、喉上抬速度减慢(OR=8.743,P<0.05)、环咽肌开放不良(OR=15.363,P<0.05)和梨状窝对比剂滞留(OR=4.186,P<0.05)是发生误吸的危险因素。结论:VFSS不仅能直观观察误吸的各种表现形式,还能有效预测患者是否有发生误吸的倾向。Objective:This paper was to explore the relationship between aspiration and abnormal pharyngeal manifestations based on video fluoroscopic swallowing study(VFSS),thus to provide evidence for clinical treatment.Methods:Dynamic videos of VFSS of 261 patients with dysphagia were retrospectively analyzed,and the occurrence of aspiration and seven abnormal pharyngeal manifestations including swallowing reflex starting delay,insufficient laryngeal uplift amplitude,reduced laryngeal uplift speed,poor ciclopharyngeal muscle opening,poor soft palate and posterior pharyngeal wall closing,pyriform sinus retention and vallecula epiglottidis retention were recorded.The correlation between the seven abnormal pharyngeal manifestations and aspiration was explored using logistic regression analysis.Results:Logistic regression analysis showed that that swallowing reflex starting delay,insufficient laryngeal uplift amplitude,reduced laryngeal uplift speed,poor ciclopharyngeal muscle opening and pyriform sinus retention were risk factors for aspiration(all P<0.05).Conclusion:VFSS can not only visually observe various manifestations of aspiration,but also effectively predict whether patients have a tendency to aspiration.

关 键 词：吞咽功能障碍 误吸 吞咽X线荧光透视检查 危险因素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R766.5[医药卫生—诊断学]