脑卒中后真假球麻痹患者吞咽相关颅脑磁共振对比研究

Contrast Research of True and False Bulbar Paralysis of Post-stroke Patients with Swallowing Associated Cerebral（MRI）

目的：探讨脑卒中后真、假性球麻痹患者吞咽困难与颅脑磁共振病变部位的联系.方法：选取脑卒中后真、假性球麻痹患者各30人,分别进行颅脑磁共振检查,同时进行临床吞咽评定及吞咽X线荧光透视检查,结果用Binary Logitic 回归分析,采用SPSS软件包（17.0版）进行处理.结果：脑卒中后真性球麻痹患者主要损伤延髓,突出表现一侧软腭运动减弱、咽反射减弱或消失、咽蠕动减弱、重复吞咽及梨状窝滞留;脑卒中后假性球麻痹患者可损害额叶、皮质下白质、锥体外系、小脑,表现口、咽、食道3阶段多种吞咽异常.结论： 脑卒中后颅脑磁共振如累及延髓的疑核、孤束核及周围网状结构,可表现真性球麻痹;累及额叶、皮质下白质、锥体外系、小脑,主要表现假性球麻痹.

Objective：To explore the relationship between dysphagia and the lesion of brain MRI in patients with the true bulbar paralysis patients and pseudo pseudobulbar palsy patients after stroke.Methods：To select thirty patients with true bulbar paralysis and pseudo pseudobulbar palsy after stroke were enrolled in this study.Brain magnetic resonance imaging （MRI） was performed, and clinical pharyngeal swallowing and pharyngeal fluoroscopy were performed.Binary Logistic regression analysis was performed using the SPSS software package （version 17.0）.Results：True bulbar paralysis after stroke in patients with primary injury of the medulla oblongata, especially on one side of the soft palate motion decreases, gag reflex weaken or disappear, pharynx peristalsis abate, repeated swallowing and piriform fossa retention;Pseudo bulbar paralysis after stroke patients can be damage to the frontal lobe, subcortical white matter, extrapyramidal, cerebellum, mouth, pharynx, esophagus, three stages of a variety of swallowing.Conclusion：Post-stroke cranial magnetic resonance, such as involving the medulla oblongata nucleus, solitary tract nucleus and the surrounding reticular structure, can manifest true bulbar paralysis;involving the frontal lobe, subcortical white matter, extrapyramidal, cerebellar, manifest pseudo bulbar paralysis.