超声引导下针刀治疗弥漫性特发性骨肥厚症所致的咽痛及吞咽困难1例  

A case of pharyngeal pain and dysphagia caused by diffuse idiopathic skeletal hyperostosis by ultrasound-guided acupotomy

作　　者：刘莉 宗邵杰 王丽[3] 张凤山[4] 李志强[5] 孟秀丽[1] LIU li;ZONG Shaojie;WANG Li;ZHANG Fengshan;LI Zhiqiang;MENG Xiuli(Department of Pain,Peking University Third Hospital,Beijing 100191,China;Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China;Department of Otolaryngology,Peking University Third Hospital,Beijing 100191,China;Department of Orthopedics,Peking University Third Hospital,Beijing 100191,China;Department of Ultrasound,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院疼痛科,北京100191 [2]北京大学第三医院麻醉科,北京100191 [3]北京大学第三医院耳鼻喉科,北京100191 [4]北京大学第三医院骨科,北京100191 [5]北京大学第三医院超声诊断科,北京100191

出　　处：《中国医药导报》2023年第32期176-179,共4页China Medical Herald

基　　金：中华人民共和国科学技术部国家重点研发计划项目(2019YFC1712101)。

摘　　要：颈椎弥漫性特发性骨肥厚症(DISH)主要特征是在至少连续4个相邻椎体的前外侧缘出现骨赘。当骨赘过大压迫食管时,患者可出现咽痛、颈部疼痛、吞咽困难等临床症状。本文报道了1例高龄伴有基础疾病的颈椎DISH患者,患者主要就医原因是咽痛和进行性吞咽困难,患者接受了超声引导下的针刀松解术,以松解患病区域的肌肉筋膜,1次/周,共10次。治疗后,患者咽痛视觉模拟评分法评分由治疗前的5分降低到治疗后的1分,EAT-10吞咽筛查量表评分由治疗前的10分降低到治疗后的3分,在5个月的后续随访中,症状没有复发。该病例治疗过程显示,针对颈椎DISH导致的咽痛和吞咽困难,超声引导下针刀松解术是一种可行、有效的治疗方法。Diffuse idiopathic skeletal hyperostosis(DISH)is characterized by the presence of osteophytes on the anterolateral margin of at least four contiguous vertebral bodies.When the osteophyte is too large to pressure the esophagus,patients may appear pharyngeal pain,neck pain,dysphagia,and other clinical symptoms.This paper reports an elderly patient with cervical DISH with underlying disease.The main reasons for the patient’s medical treatment were pharyngeal pain and progressive dysphagia,the patient underwent ultrasound-guided acupotomy to release the muscular fascia in the affected area,once a week,ten times in total.After treatment,the visual analog score of patients with pharyngeal pain decreased from five points before treatment to one point after treatment,the score of eating assessment tool-10 swallowing screening scale decreased from ten points before treatment to three points after treatment,at five months of follow-up,the patient’s symptoms did not recur.The treatment process of this case showed that ultrasound-guided acupotomy release is a feasible and effective treatment for pharyngeal pain and dysphagia caused by DISH in the cervical spine.

关 键 词：弥漫性特发性骨肥厚症 超声引导下针刀治疗 咽痛 吞咽困难 

分 类 号：R681[医药卫生—骨科学]