环咽肌失弛缓症的研究进展

doi:10.3969/j.issn.1006-9771.2020.03.015

摘要/Abstract

摘要：

环咽肌是食管上括约肌的重要组成部分,其功能性开放不完全或完全不能开放而造成的吞咽障碍称为环咽肌失弛缓症(CPD)。神经系统疾病和头颈部肿瘤等均可导致CPD,发病机制尚未完全阐明。CPD的诊断依靠临床表现和吞咽功能评估,如吞咽造影检查、食管测压和电生理检查。食管测压并不是金标准,应与吞咽造影检查结合进行。治疗措施包括吞咽训练、球囊扩张、肉毒毒素注射和环咽肌切开术。喉上抬正常且咽部肌肉功能良好的患者治疗效果通常较好。球囊扩张目前较为常用。环咽肌切开术成功率高于肉毒毒素注射治疗。三种技术各有优缺点,各自的适应症、禁忌症和患者选择等问题有待进一步研究。

关键词: 环咽肌失弛缓症, 发病机制, 诊断, 治疗, 综述

Abstract:

Cricopharyngeus muscle (CPM) is an important component of upper esophageal sphincter. It is termed cricopharyngeus dysfunction (CPD) if CPM fails to relax, which may be second to neurologic or neoplastic disease. However, the pathogenesis is not yet clear. The diagnosis of CPD would combine clinical features and swallowing evalutions, such as videofluoroscopic swallowing study, pharyngeal manometry and electromyogram, etc. Esophageal manometry is not the golden standard and should be combined with videofluoroscopic swallowing study. Interventions include swallowing exercise, pharyngoesophageal balloon dilatation, Botulinum toxin injection and cricopharyngeus myotomy. The outcomes will be better in those with intact laryngeal elevation and pharyngeal contraction. Balloon dilation is more commonly used. The success rate of cricopharyngeus myotomy is reported higher than that of Botulinum toxin injection. Each of the three technologies has their advantages, and it needs more researches to study their indications, contraindications and patient selection.

Key words: cricopharyngeal dysfunction, pathogenesis, diagnosis, treatment, review

中图分类号:

R493

张祎辰,高正玉,王强,张春佳,王瞳,罗慧. 环咽肌失弛缓症的研究进展[J]. 《中国康复理论与实践》, 2020, 26(3): 339-343.

ZHANG Yi-chen,GAO Zheng-yu,WANG Qiang,ZHANG Chun-jia,WANG Tong,LUO Hui. Advance in Cricopharyngeal Dysfunction (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(3): 339-343.

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