电视荧光放射录相术对中风后吞咽障碍检查的临床价值

Clinical Value of Video Flurography in the Examination of Dysphagia after Stroke

目的 探讨电视荧光放射录相术 (VFG)对中风后吞咽障碍检查的价值。材料与方法 中风后吞咽障碍组 6 0例和健康中老年人组 2 0例行 VFG,分别记录两组受试者吞咽稀钡及半胶钡 (含钡面糊 )过程中的口通过时间和咽通过时间 ,并评价口、咽功能 ,记录有无舌肌运动减弱 ,钡剂残留梨状隐窝、会厌奚谷 ,是否误吸入气管。结果 (1)吞咽障碍组各吞咽时相通过时间均较健康中老年组延长。 (2 )会厌奚谷钡剂残留在患者中发生率最高 (45 .0 % ;33.3% ) ,梨状隐窝钡剂残留发生率较高 (35 .0 % ;2 5 .0 % )。脑干病变组各病理征象发生率均高于大脑半球病变组。经统计学处理 ,脑干病变组与大脑半球病变组误吸发生率有显著性差异 (P<0 .0 5 )。结论 VFG可以对吞咽全过程特别是咽时相的病理征象进行更详细的观察 。

Objective To explore the clinical value of video flurography (VFG) in the examination of dysphagia after stroke.Materials and Methods VFG recording was performed in study group (60 patients) and control group (20 healthy aged people). Swallowing function was evaluated by observing the pathological signs, such as reduced lingual control, residual barium in the pyriform fossae and epiglottic valleculae, aspiration into the airway, etc.Results (1) The passing time of the barium in study group was significantly longer than that in control group. (2) Residual barium in the epiglottic valleculae was a common finding in study group, and not uncommon in pyriform fossae. The incidence of the pathological signs in the patients with lesions in brain stem was higher than that in the patients with lesions in cerebral hemisphere. The difference in the occurrence of inspiration into the airway between patients with brain stem lesions and patients with cerebral hemisphere lesions was statistically significant (P<0.05). Conclusion VGF can observe the whole course of swallowing, especially the pathological signs during pharyngeal phase, thus, it is a valuable examination for dysphagia after stroke.