泛影葡胺吞咽造影评定卒中后吞咽障碍的临床观察

Clinical Observation of Dysphagia after Stroke Evaluated by Videofluoroscopic Swallowing Study with Meglumine Diatrizoate

目的探讨一种安全有效的评定卒中后吞咽功能障碍的方法。方法采用20%泛影葡胺液调制液态及糊状造影剂,对40例卒中后吞咽障碍患者进行吞咽造影评定,分析影像学表现以得出吞咽障碍类型,并据此提供有针对性的个体化治疗方案以指导吞咽功能训练。结果 40例患者均能清晰观察到整个吞咽过程,显示出口腔期及咽期的滞留、残留、渗透、误吸及清除情况等,并且2种不同形态的造影剂在显示误吸方面比较存在统计学差异(P<0.05);在评定后接受个体化吞咽训练2周,40例患者的吞咽功能改善,其总有效率达72.5%,且均未发生与造影相关的并发症。结论泛影葡胺吞咽造影检查能安全有效地评定卒中后吞咽障碍患者的吞咽功能,指导吞咽训练及患者的饮食方式。

Objective To explore a safe and effective assessment method for dysphagia after stroke.Methods Totally 40 patients with dysphagia after stroke were evaluated by videofluoroscopic swallowing study with 20％ meglumine diatrizoate and 20％ meglumine diatrizoate mixed food thickener.Then the imaging features were analyzed to draw conclusions which can provide targeted individualized treatment plan.Results The entire process of swallowing,including pooling,residuals,penetration,aspiration,clearance,etc,could be observed clearly.There was a significant difference （P ＜ 0.05） between two different forms of contrast agents in displaying aspiration.While we receiving targeted individualized treatment two weeks,40 patients＇ swallowing function have improved.The overall effect was 72.5％.The complications of study-related did not occur.Conclusion Videofluoroscopic swallowing study with meglumine diatrizoate can reflect the swallowing function in dysphagia after stroke safely and effectively,guide dysphagia rehabilitation,also instruct the patients＇ diet.