《中国康复理论与实践》

《中国康复理论与实践》 ›› 2011, Vol. 17 ›› Issue (12): 1107-1111.

• 论文 • 上一篇    下一篇

电视透视下吞咽能力检查在口咽期吞咽障碍中的应用

万萍1，Ding Ruiying2，祝乐群3，黄立4，张宏4，黄昭鸣5   

  1. 1.上海中医药大学康复医学院现代康复技术教研室，上海市 201203；2.Dept. of Communication Sciences and Disorders，University of Wisconsin-Whitewater；3.上海中医药大学附属岳阳中西医结合医院放射科，上海市 200437；4.上海中医药大学附属岳阳中西医结合医院康复科，上海市 200437；5.华东师范大学言语听觉科学教育部重点实验室，上海市 200062。
  • 收稿日期:2011-08-29 修回日期:2011-09-26 出版日期:2011-12-25 发布日期:2011-12-25
  • 通讯作者: Ding Ruiying

Oropharyngeal Swallowing Disorders under Videofluoroscopic Swallowing Study

WAN Ping, Ding Ruiying, ZHU Le-qun, et al.   

  1. Shanghai University of TCM, Shanghai 201203, China
  • Received:2011-08-29 Revised:2011-09-26 Published:2011-12-25 Online:2011-12-25

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被引次数

6

摘要： 目的分析吞咽障碍患者电视透视下吞咽能力检查(VFSS)结果。方法16例知情同意吞咽障碍患者接受VFSS检查。分别采用稀钡餐(50%w/v)、稠钡餐(270%w/v)、饼干沾稠钡餐进行咀嚼测试。一口量为10ml。采用正位、侧位动态造影测试，依次观察双侧梨状窝对称情况、口期时长、咽期起始时间、咽期时长、滞留、误吸及其时间、剂量等。结果5例为口期吞咽障碍；3例为咽期吞咽障碍，显示存在咽期起始迟缓，并且有1例表现为吞咽后误吸；8例为口咽期吞咽障碍，其中5例不伴误吸，3例伴有误吸，其中2例为安静误吸，1例表现为吞咽前误吸，1例表现为吞咽后误吸(梨状窝滞留引起)，1例无法判断误吸时间。4例误吸患者中，3例存在钡剂25%以上的重度误吸，1例存在5%的轻度误吸，同时配合吞咽康复治疗。结论VFSS检测可为制订吞咽障碍的康复方案提供参考。

关键词: 吞咽障碍, 电视透视下吞咽能力检查, 吞咽治疗

Abstract: Objective To explore oropharyngeal swallowing disorders with videofluoroscopic swallowing study (VFSS). Methods 16 patients with dysphagia accepted VFSS with 10 ml of thin barium meal (50% w/v), thick barium meal (270% w/v), biscuit coated with thick barium meal in single swallow. Their swallowing function was observed on the lateral and anterior/posterior planes, including: symmetry of pyriform sinuses, oral transit time, presence of pharyngeal delay, pharyngeal transit time, oral and pharyngeal residue, and presence of aspiration.Results 5 patients demonstrated oral swallowing disorder. 3 patients demonstrated pharyngeal swallowing disorders, that was pharyngeal delay which caused in aspiration after swallowing. 8 patients demonstrated oropharyngeal swallowing disorders, and 3 of them presented aspiration,2 patients were silent aspirators, 1 was aspiration before and 1 after swallowing. The aspiration time could not be judged from the videofluoroscopy in the other one. For 4 patients with aspiration, 3 were severe, with more than 25% of the bolus aspirated, and 1 aspirated less than 5%. Conclusion VFSS can be helpful to plan individual rehabilitation.

Key words: dysphagia, videofluoroscopic study, swallowing treatment