应用纤维鼻咽喉镜吞咽检查联合新斯的明试验评价重症肌无力患者吞咽功能的临床研究

Practice of fiberoptic endoscopic examination of swallowing combined with neostigmine test in myasthenia gravis

目的:探讨纤维鼻咽喉镜吞咽功能检查联合新斯的明试验(FNT)在重症肌无力(MG)相关吞咽障碍中的应用价值。方法:对4例存在吞咽障碍症状,已确诊或疑诊MG的患者进行FNT试验。结果:3例患者FNT试验为阳性。其中1例以吞咽障碍为首发症状的患者诊断为MG;1例已确诊MG的患者被证实其胸腺瘤切除术后出现的吞咽障碍是由于MG引起的;1例患者被发现存在MG相关的吞咽疲劳现象。FNT试验阴性的1例患者诊断为运动神经元病。结论:FNT试验在MG相关吞咽障碍的诊断和处理中是一个非常有价值的评估工具。

Objective：To evaluate the practice value of fiberoptic endoscopic examination of swallowing combined with neostigmine test（FNT） in diagnosis and treatment of dysphagia in myasthenia gravis（MG） patients.Method：Four MG patients with dysphagia symptom received FNT.FNT was performed following a standardized protocol.Result：Three patients were rated as being positive on FNT.Of them,FNT was helpful to confirm the diagnosis of MG in case 1 with dysphagia as his first symptom.In case 2 with confirmed MG,FNT suggested his dysphagia following thymomaectomy was due to MG.And FNT showed MG related fatigable swallowing in case 3.Case 4 with negative FNT was diagnosed as motor neuron disease.Conclusion：FNT is a valuable tool for evaluating and managing dysphagia in MG patients.