超声引导下肉毒毒素环咽肌注射治疗延髓背外侧综合征所致吞咽障碍1例报道

doi:10.3969/j.issn.1006-9771.2020.11.020

《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (11): 1358-1364.doi: 10.3969/j.issn.1006-9771.2020.11.020

• 临床观察 • 上一篇

超声引导下肉毒毒素环咽肌注射治疗延髓背外侧综合征所致吞咽障碍1例报道

杨瑛^1,^2a,许梅娜^2b,李相良^2c,谢峦^2a,金海鹏^2c()

1.福建中医药大学,福建福州市 350122
2a.北京中医药大学厦门医院, 针灸学院,福建厦门市 361009
2b.北京中医药大学厦门医院, 超声医学科,福建厦门市 361009
2c.北京中医药大学厦门医院, 针灸康复科,福建厦门市 361009

收稿日期:2020-02-16 修回日期:2020-09-02 出版日期:2020-11-25 发布日期:2020-11-24
通讯作者: 金海鹏 E-mail:13066081@qq.com
作者简介:杨瑛(1996-),女,汉族,福建莆田市人,硕士研究生,主要研究方向：针灸治疗脑病的临床研究。|金海鹏(1977-),男,汉族,上海市人,硕士,副主任医师,硕士研究生导师,主要研究方向：针刺结合康复治疗神经系统疾病。

Cricopharyngeal Botulinum Toxin Injection under Ultrasonic Guidance for Dysphagia from Wallenberg’s Syndrome: A Case Report

YANG Ying^1,^2a,XU Mei-na^2b,LI Xiang-liang^2c,XIE Luan^2a,JIN Hai-peng^2c()

1. Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China
2a. College of Acupuncture, Xiamen Hospital of Beijing University of Traditional Chinese Medicine, Xiamen, Fujian 361009, China
2b. Department of Ultrasound Medicine, Xiamen Hospital of Beijing University of Traditional Chinese Medicine, Xiamen, Fujian 361009, China
2c. Acupuncture Rehabilitation Department, Xiamen Hospital of Beijing University of Traditional Chinese Medicine, Xiamen, Fujian 361009, China

Received:2020-02-16 Revised:2020-09-02 Published:2020-11-25 Online:2020-11-24
Contact: JIN Hai-peng E-mail:13066081@qq.com

摘要/Abstract

摘要：

目的采用超声引导下肉毒毒素环咽肌注射治疗延髓背外侧综合征所致吞咽障碍。方法回顾本院1例临床资料。结果患者延髓背外侧梗死后,导致环咽肌失弛缓,经常规吞咽治疗和球囊扩张术后未见明显好转,予超声引导下肉毒毒素环咽肌注射,经藤岛一郎摄食-吞咽功能等级量表、Rosenbek渗漏-误吸量表评定和透视荧光吞咽检查分析,吞咽功能改善,治疗后1个月和3个月随访,吞咽功能正常。结论超声引导下肉毒毒素注射治疗延髓背外侧综合征所致环咽肌失弛缓有一定的近期和远期效果。

关键词: 延髓背外侧综合征, 吞咽障碍, 环咽肌失弛缓, 肉毒毒素, 超声引导

Abstract:

Objective To investigate the effect of cricopharyngeal injection of Botulinum toxin under ultrasonic guidance for treatment of dysphagia caused by Wallenberg’s syndrome.Methods A case was reviewed.Results This patient was diagnosed as cricopharyngeal achalasia after dorsal lateral rostral infarction, and responded poor to routine treatment for swallowing disorders, including balloon dilatation. He accepted cricopharyngeal Botulinum toxin injection under ultrasonic guidance. As evaluated with Toshima Ichiro Ingestion-Swallowing Function Rating Scale, Rosenbek Penetration-Aspiration Scale and videofluoroscopic swallowing study (VFSS), his swallowing improved after treatment, and became normal as follow-up one and three months after treatment.Conclusion Cricopharyngeal Botulinum toxin injection under ultrasonic guidance is feasible for cricopharyngeal achalasia of Wallenberg’s syndrome with immediate and long-term effect.

Key words: Wallenberg’s syndrome, dysphagia, cricopharyngeal achalasia, Botulinum toxin, ultrasonic guidance

中图分类号:

R743.3

杨瑛,许梅娜,李相良,谢峦,金海鹏. 超声引导下肉毒毒素环咽肌注射治疗延髓背外侧综合征所致吞咽障碍1例报道[J]. 《中国康复理论与实践》, 2020, 26(11): 1358-1364.

YANG Ying,XU Mei-na,LI Xiang-liang,XIE Luan,JIN Hai-peng. Cricopharyngeal Botulinum Toxin Injection under Ultrasonic Guidance for Dysphagia from Wallenberg’s Syndrome: A Case Report[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(11): 1358-1364.

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参考文献 30

[1]	胡杰, 许瑞卿, 吕祥龙, 等. 延髓背外侧综合征临床分析[J]. 中国现代神经疾病杂志, 2019, 19(1):41-46.
	Hu J, Xu R Q, Lü X L, et al. Clinical analysis of Wallenberg’s syndrome[J]. Chin J Contemp Neurol Neurosurg, 2019, 19(1):41-46.
[2]	贾建平. 神经病学[M]. 北京: 人民卫生出版社, 2013: 14.
	Jia J P. Neurology [M]. Beijing: People’s Medical Publishing House, 2013: 14.
[3]	王德周. 延髓背外侧综合征36例临床分析[J]. 中国实用神经疾病杂志, 2011, 14(15):62-63.
	王德周. 延髓背外侧综合征36例临床分析[J]. 中国实用神经疾病杂志, 2011, 14(15):62-63.
	Wang D Z. Clinical analysis of 36 cases of Wallenberg’s syndrome[J]. Chin J of Prac Nerv Dis, 2011, 14(15):62-63.
	Wang D Z. Clinical analysis of 36 cases of Wallenberg’s syndrome[J]. Chin J of Prac Nerv Dis, 2011, 14(15):62-63.
[4]	张弘娟, 郭文玲, 邵春香. 延髓背外侧综合征42例临床及影像学分析[J]. 中国实用医药, 2014, 9(11):135-136.
	张弘娟, 郭文玲, 邵春香. 延髓背外侧综合征42例临床及影像学分析[J]. 中国实用医药, 2014, 9(11):135-136.
	Zhang H J, Guo W L, Shao C X. Clinical and imaging analysis of 42 cases of Wallenberg’s syndrome[J]. Chin Prac Med, 2014, 9(11):135-136.
	Zhang H J, Guo W L, Shao C X. Clinical and imaging analysis of 42 cases of Wallenberg’s syndrome[J]. Chin Prac Med, 2014, 9(11):135-136.
[5]	袁永学. 延髓背外侧综合征伴吞咽障碍的概述[C]. 北京:第十届北京国际康复论坛, 2015.
	袁永学. 延髓背外侧综合征伴吞咽障碍的概述[C]. 北京:第十届北京国际康复论坛, 2015.
	Yuan Y X. Overview of Wallenberg’s syndrome with dysphagia[C]. Beijing: The 10th Beijing International Rehabilitation Forum, 2015.
	Yuan Y X. Overview of Wallenberg’s syndrome with dysphagia[C]. Beijing: The 10th Beijing International Rehabilitation Forum, 2015.
[6]	兰月, 窦祖林, 万桂芳, 等. 球囊扩张术治疗脑干病变后环咽肌失弛缓症的疗效研究[J]. 中华物理医学与康复杂志, 2009, 31(12):835-838.
	兰月, 窦祖林, 万桂芳, 等. 球囊扩张术治疗脑干病变后环咽肌失弛缓症的疗效研究[J]. 中华物理医学与康复杂志, 2009, 31(12):835-838.
	Lan Y, Dou Z L, Wan G F, et al. Efficacy of balloon dilatation therapy for cricopharyngeal achalasia in patients with brainstem lesions[J]. Chin J Phys Med Rehabil, 2009, 31(12):835-838.
	Lan Y, Dou Z L, Wan G F, et al. Efficacy of balloon dilatation therapy for cricopharyngeal achalasia in patients with brainstem lesions[J]. Chin J Phys Med Rehabil, 2009, 31(12):835-838.
[7]	Kelly E A, Koszewski I J, Jaradeh S S, et al. Botulinum toxin injection for the treatment of upper esophageal sphincter dysfunction[J]. Ann Otol Rhinol Laryngol, 2013, 122(2):100-108. doi: 10.1177/000348941312200205
	Kelly E A, Koszewski I J, Jaradeh S S, et al. Botulinum toxin injection for the treatment of upper esophageal sphincter dysfunction[J]. Ann Otol Rhinol Laryngol, 2013, 122(2):100-108. doi: 10.1177/000348941312200205
[8]	Kim S M, Kim G W, Rho Y S, et al. Office-based electromyography-guided Botulinum toxin injection to the cricopharyngeus muscle: optimal patient selection and technique[J]. Ann Otol Rhinol Laryngol, 2017, 126(5):349-356. doi: 10.1177/0003489416689469
	Kim S M, Kim G W, Rho Y S, et al. Office-based electromyography-guided Botulinum toxin injection to the cricopharyngeus muscle: optimal patient selection and technique[J]. Ann Otol Rhinol Laryngol, 2017, 126(5):349-356. doi: 10.1177/0003489416689469
[9]	Jeonq S H, Kim Y J, Kim Y J, et al. Endoscopic Botulinum toxin injection for treatment of pharyngeal dysphagia in patients with cricopharyngeal dysfunction[J]. Scand J Gastroenterol, 2018, 53(10):1201-1205. doi: 10.1080/00365521.2018.1506820
	Jeonq S H, Kim Y J, Kim Y J, et al. Endoscopic Botulinum toxin injection for treatment of pharyngeal dysphagia in patients with cricopharyngeal dysfunction[J]. Scand J Gastroenterol, 2018, 53(10):1201-1205. doi: 10.1080/00365521.2018.1506820
[10]	王利春, 黄凤慧, 苗维, 等. CT引导下肉毒毒素环咽肌注射治疗真性延髓麻痹所致吞咽障碍1例报道[J]. 中国康复理论与实践, 2019, 25(4):477-480.
	王利春, 黄凤慧, 苗维, 等. CT引导下肉毒毒素环咽肌注射治疗真性延髓麻痹所致吞咽障碍1例报道[J]. 中国康复理论与实践, 2019, 25(4):477-480.
	Wang L C, Huang F H, Miao W, et al. CT-guided Botulinum toxin injection into cricopharyngeus for dysphagia after true bulbar palsy: a case report[J]. Chin J Rehabil Theory Pract, 2019, 25(4):477-480.
	Wang L C, Huang F H, Miao W, et al. CT-guided Botulinum toxin injection into cricopharyngeus for dysphagia after true bulbar palsy: a case report[J]. Chin J Rehabil Theory Pract, 2019, 25(4):477-480.
[11]	温红梅, 万桂芳, 唐志明, 等. 超声、球囊联合肌电引导注射肉毒毒素治疗脑卒中后环咽肌失弛缓:1例报告[J]. 中国康复医学杂志, 2019, 34(9):1088-1091.
	温红梅, 万桂芳, 唐志明, 等. 超声、球囊联合肌电引导注射肉毒毒素治疗脑卒中后环咽肌失弛缓:1例报告[J]. 中国康复医学杂志, 2019, 34(9):1088-1091.
	Wen H M, Wan G F, Tang Z M, et al. Ultrasound, balloon combined with electromyography guided injection of Botulinum toxin for the treatment of circulatory achalasia after stroke: a case report[J]. Chin J Rehabil Med, 2019, 34(9):1088-1091.
	Wen H M, Wan G F, Tang Z M, et al. Ultrasound, balloon combined with electromyography guided injection of Botulinum toxin for the treatment of circulatory achalasia after stroke: a case report[J]. Chin J Rehabil Med, 2019, 34(9):1088-1091.
[12]	王修敏, 夏清. 环咽肌失弛缓症与环咽肌功能障碍辨析[J]. 中华物理医学与康复杂志, 2016, 38(12):958-960.
	王修敏, 夏清. 环咽肌失弛缓症与环咽肌功能障碍辨析[J]. 中华物理医学与康复杂志, 2016, 38(12):958-960.
	Wang X M, Xia Q. Discrimination between achalasia of circumpharyngeal muscle and dysfunction of circumpharyngeal muscle[J]. Chin J Phys Med Rehabil, 2016, 38(12):958-960.
	Wang X M, Xia Q. Discrimination between achalasia of circumpharyngeal muscle and dysfunction of circumpharyngeal muscle[J]. Chin J Phys Med Rehabil, 2016, 38(12):958-960.
[13]	袁英, 汪洁, 黄小波, 等. 吞咽功能的中枢及周围神经调控机制[J]. 中国康复医学杂志, 2018, 33(12):1479-1482.
	袁英, 汪洁, 黄小波, 等. 吞咽功能的中枢及周围神经调控机制[J]. 中国康复医学杂志, 2018, 33(12):1479-1482.
	Yuan Y, Wang J, Huang X B, et al. Regulation mechanism of central and peripheral nerves of swallowing function[J]. Chin J Rehabil Med, 2018, 33(12):1479-1482.
	Yuan Y, Wang J, Huang X B, et al. Regulation mechanism of central and peripheral nerves of swallowing function[J]. Chin J Rehabil Med, 2018, 33(12):1479-1482.
[14]	Ertekin C, Turman B, Tarlaci S, et al. Cricopharyngeal sphincter muscle responses to transcranial magnetic stimulation in normal subjects and in patients with dysphagia[J]. Clin Neurophysiol, 2001, 112(1):86-94. pmid: 11137665
	Ertekin C, Turman B, Tarlaci S, et al. Cricopharyngeal sphincter muscle responses to transcranial magnetic stimulation in normal subjects and in patients with dysphagia[J]. Clin Neurophysiol, 2001, 112(1):86-94. pmid: 11137665
[15]	李眺, 曾小香, 蔺丽娟, 等. 球囊扩张术联合针刺治疗脑干梗死后环咽肌失弛缓症:随机对照研究[J]. 中国针灸, 2019, 39(10):1027-1033.
	李眺, 曾小香, 蔺丽娟, 等. 球囊扩张术联合针刺治疗脑干梗死后环咽肌失弛缓症:随机对照研究[J]. 中国针灸, 2019, 39(10):1027-1033.
	Li T, Zeng X X, Lin L J, et al. Catheter balloon dilation combined with acupuncture for cricopharyngeal achalasia after brain stem infarction: a randomized controlled trial[J]. Chin Acup Moxib, 2019, 39(10):1027-1033.
	Li T, Zeng X X, Lin L J, et al. Catheter balloon dilation combined with acupuncture for cricopharyngeal achalasia after brain stem infarction: a randomized controlled trial[J]. Chin Acup Moxib, 2019, 39(10):1027-1033.
[16]	Mohan S, Bowe S N, Hirner L M, et al. Modified approach for pediatric external cricopharyngeal myotomy[J]. Int J Pediatr Otorhinolaryngol, 2018, 105:111-114. doi: 10.1016/j.ijporl.2017.12.019
	Mohan S, Bowe S N, Hirner L M, et al. Modified approach for pediatric external cricopharyngeal myotomy[J]. Int J Pediatr Otorhinolaryngol, 2018, 105:111-114. doi: 10.1016/j.ijporl.2017.12.019
[17]	Lau K, Watson M G. Pharyngeal pouch: comparison of surgical treatment with Botulinum toxin injection to the cricopharyngeus[J]. J Laryngol Oto, 2019, 133(2):125-128.
	Lau K, Watson M G. Pharyngeal pouch: comparison of surgical treatment with Botulinum toxin injection to the cricopharyngeus[J]. J Laryngol Oto, 2019, 133(2):125-128.
[18]	周梦婷, 杨海云, 姚继祎, 等. 超声引导下肉毒杆菌毒素治疗环咽肌功能障碍的进展[J]. 岭南现代临床外科, 2019, 19(5):619-622.
	周梦婷, 杨海云, 姚继祎, 等. 超声引导下肉毒杆菌毒素治疗环咽肌功能障碍的进展[J]. 岭南现代临床外科, 2019, 19(5):619-622.
	Zhou M T, Yang H Y, Yao J Y, et al. Progress in treatment of cricopharyngeal dysfunction with ultrasound-guided Botulinum toxin[J]. Lingnan Modern Clin Surg, 2019, 19(5):619-622.
	Zhou M T, Yang H Y, Yao J Y, et al. Progress in treatment of cricopharyngeal dysfunction with ultrasound-guided Botulinum toxin[J]. Lingnan Modern Clin Surg, 2019, 19(5):619-622.
[19]	Chao J B, Goodman J, Fuson A, et al. Hypopharyngeal applications of a new flexible robotic system in otolaryngology[J]. J Robot Surg, 2018, 12(3):571-574. doi: 10.1007/s11701-017-0756-3
	Chao J B, Goodman J, Fuson A, et al. Hypopharyngeal applications of a new flexible robotic system in otolaryngology[J]. J Robot Surg, 2018, 12(3):571-574. doi: 10.1007/s11701-017-0756-3
[20]	Sharma S D, Kumar G, Eweiss A, et al. Endoscopic-guided injection of Botulinum toxin into the cricopharyngeus muscle: our experience[J]. J Laryngol Otol, 2015, 129(10):990-995. doi: 10.1017/S0022215115002327 pmid: 26446761
	Sharma S D, Kumar G, Eweiss A, et al. Endoscopic-guided injection of Botulinum toxin into the cricopharyngeus muscle: our experience[J]. J Laryngol Otol, 2015, 129(10):990-995. doi: 10.1017/S0022215115002327 pmid: 26446761
[21]	张学敏, 毕胜, 许亚飞, 等. 超声引导下A型肉毒毒素注射治疗脑干梗死环咽肌失弛缓症1例报告[J]. 中国康复医学杂志, 2019, 34(2):216-218.
	张学敏, 毕胜, 许亚飞, 等. 超声引导下A型肉毒毒素注射治疗脑干梗死环咽肌失弛缓症1例报告[J]. 中国康复医学杂志, 2019, 34(2):216-218.
	Zhang X M, Bi S, Xu Y F, et al. Ultrasound-guided Botulinum toxin A injection in the treatment of achalasia of the cricopharyngeus muscle in brainstem infarction: a case report[J]. Chin J Rehabil Med, 2019, 34(2):216-218.
	Zhang X M, Bi S, Xu Y F, et al. Ultrasound-guided Botulinum toxin A injection in the treatment of achalasia of the cricopharyngeus muscle in brainstem infarction: a case report[J]. Chin J Rehabil Med, 2019, 34(2):216-218.
[22]	林晓婷, 杨海云, 栗晓, 等. 超声引导肉毒毒素注射治疗环咽肌功能障碍探讨[J]. 中山大学学报(医学版), 2018, 39(3):472-476.
	林晓婷, 杨海云, 栗晓, 等. 超声引导肉毒毒素注射治疗环咽肌功能障碍探讨[J]. 中山大学学报(医学版), 2018, 39(3):472-476.
	Lin X T, Yang H Y, Li X, et al. Therapeutic effects of ultrasound-guided injection of Botulinum toxin type A into the cricopharyngeus muscle for cricopharyngeal dysfunction[J]. J Sun Yat-sen Univ (Medical Sciences), 2018, 39(3):472-476.
	Lin X T, Yang H Y, Li X, et al. Therapeutic effects of ultrasound-guided injection of Botulinum toxin type A into the cricopharyngeus muscle for cricopharyngeal dysfunction[J]. J Sun Yat-sen Univ (Medical Sciences), 2018, 39(3):472-476.
[23]	Wei P, Xu Y, Zhang Z, et al. Treatment for upper esophageal sphincter dysfunction in a patient with poststroke dysphagia: a case report[J]. Medicine, 2019, 98(13):1-4.
	Wei P, Xu Y, Zhang Z, et al. Treatment for upper esophageal sphincter dysfunction in a patient with poststroke dysphagia: a case report[J]. Medicine, 2019, 98(13):1-4.
[24]	方卫平. 超声内镜对老年患者食管平滑肌瘤的诊治价值研究[D]. 杭州:浙江大学, 2016.
	方卫平. 超声内镜对老年患者食管平滑肌瘤的诊治价值研究[D]. 杭州:浙江大学, 2016.
	Fang W P. Clinical value of endoscopic ultrasonography for esophageal leiomyoma in elder patients[D]. Hangzhou: Zhejiang University, 2016.
	Fang W P. Clinical value of endoscopic ultrasonography for esophageal leiomyoma in elder patients[D]. Hangzhou: Zhejiang University, 2016.
[25]	朱尚勇, 刘若川, 杨红, 等. 食管颈部的超声解剖及声像图研究[J]. 中华超声影像学杂志, 2001, 10(7):435-437.
	朱尚勇, 刘若川, 杨红, 等. 食管颈部的超声解剖及声像图研究[J]. 中华超声影像学杂志, 2001, 10(7):435-437.
	Zhu S Y, Liu R C, Yang H, et al. A study on the ultrasound anatomy and ultrasonography of the cervical esophagus[J]. Chin J Ultrasonogr, 2001, 10(7):435-437.
	Zhu S Y, Liu R C, Yang H, et al. A study on the ultrasound anatomy and ultrasonography of the cervical esophagus[J]. Chin J Ultrasonogr, 2001, 10(7):435-437.
[26]	Morinière S, Hammoudi K, Marmouset F, et al. Ultrasound analysis of the upper esophageal sphincter during swallowing in the healthy subject[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2013, 130(6):321-325. doi: 10.1016/j.anorl.2012.01.008 pmid: 23845296
	Morinière S, Hammoudi K, Marmouset F, et al. Ultrasound analysis of the upper esophageal sphincter during swallowing in the healthy subject[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2013, 130(6):321-325. doi: 10.1016/j.anorl.2012.01.008 pmid: 23845296
[27]	Ertekin C, Aydogdu I. Neurophysiology of swallowing[J]. Clin Neurophysiol, 2003, 114(12):2226-2244. pmid: 14652082
	Ertekin C, Aydogdu I. Neurophysiology of swallowing[J]. Clin Neurophysiol, 2003, 114(12):2226-2244. pmid: 14652082
[28]	胡佑红, 卫小梅, 窦祖林. 导管球囊扩张治疗环咽肌功能障碍的机制[J]. 中华脑科疾病与康复杂志:电子版, 2011, 1(1):82-87.
	胡佑红, 卫小梅, 窦祖林. 导管球囊扩张治疗环咽肌功能障碍的机制[J]. 中华脑科疾病与康复杂志:电子版, 2011, 1(1):82-87.
	Hu Y H, Wei X M, Dou Z L. Mechanisms of catheter balloon dilatation therapy for cricopharyngeal dysfunction[J]. Chin J Brain Dis Rehabil (Electronic Edition), 2011, 1(1):82-87.
	Hu Y H, Wei X M, Dou Z L. Mechanisms of catheter balloon dilatation therapy for cricopharyngeal dysfunction[J]. Chin J Brain Dis Rehabil (Electronic Edition), 2011, 1(1):82-87.
[29]	李晏. 神经肌肉电刺激对脑卒中伴吞咽障碍患者疗效及生活质量的影响[J]. 河北医学, 2017, 23(4):576-580.
	李晏. 神经肌肉电刺激对脑卒中伴吞咽障碍患者疗效及生活质量的影响[J]. 河北医学, 2017, 23(4):576-580.
	Li Y. Effect of neuromuscular electrical stimulation on the efficacy and quality of life in patients with dysphagia after stroke[J]. Hebei Med, 2017, 23(4):576-580.
	Li Y. Effect of neuromuscular electrical stimulation on the efficacy and quality of life in patients with dysphagia after stroke[J]. Hebei Med, 2017, 23(4):576-580.
[30]	刘有山. 神经肌肉电刺激联合吞咽康复训练治疗脑卒中后吞咽障碍的疗效及其对舌骨喉复合体动度的影响[J]. 中华全科医学, 2017, 15(10):1782-1785.
	刘有山. 神经肌肉电刺激联合吞咽康复训练治疗脑卒中后吞咽障碍的疗效及其对舌骨喉复合体动度的影响[J]. 中华全科医学, 2017, 15(10):1782-1785.
	Liu Y S. Effect of neuromuscular electrical stimulation combined with swallowing rehabilitation training on post-stroke dysphagia and its effect on movement of the hyo-laryngeal complex[J]. Chin J General Prac, 2017, 15(10):1782-1785.
	Liu Y S. Effect of neuromuscular electrical stimulation combined with swallowing rehabilitation training on post-stroke dysphagia and its effect on movement of the hyo-laryngeal complex[J]. Chin J General Prac, 2017, 15(10):1782-1785.

时间	藤岛一郎摄食-吞咽功能	渗漏-误吸量表
常规治疗前	2	8
常规治疗1周后	3	8
A型肉毒毒素治疗后第2天	9	1
出院后1个月	10	1
出院后3个月	10	1

时间	藤岛一郎摄食-吞咽功能	渗漏-误吸量表
常规治疗前	2	8
常规治疗1周后	3	8
A型肉毒毒素治疗后第2天	9	1
出院后1个月	10	1
出院后3个月	10	1

时间	舌骨上移 (mm)	舌骨前移 (mm)	甲状软骨上移 (mm)	甲状软骨前移 (mm)	UES开放时间 (s)	UES开放幅度 (cm)	咽腔收缩率 (%)
常规治疗前	11	2	14	3	0.3	0.6	71.5
常规治疗1周后	12	3	17	3	0.4	0.7	73.4
A型肉毒毒素治疗后第2天	13	10	19	4	0.8	0.8	92.6
出院后1个月	18	12	21	5	0.9	1.0	94.9
出院后3个月	20	13	21	6	1.1	1.1	98.0

时间	舌骨上移 (mm)	舌骨前移 (mm)	甲状软骨上移 (mm)	甲状软骨前移 (mm)	UES开放时间 (s)	UES开放幅度 (cm)	咽腔收缩率 (%)
常规治疗前	11	2	14	3	0.3	0.6	71.5
常规治疗1周后	12	3	17	3	0.4	0.7	73.4
A型肉毒毒素治疗后第2天	13	10	19	4	0.8	0.8	92.6
出院后1个月	18	12	21	5	0.9	1.0	94.9
出院后3个月	20	13	21	6	1.1	1.1	98.0

超声引导下肉毒毒素环咽肌注射治疗延髓背外侧综合征所致吞咽障碍1例报道

Cricopharyngeal Botulinum Toxin Injection under Ultrasonic Guidance for Dysphagia from Wallenberg’s Syndrome: A Case Report

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