超声在延髓背外侧综合征所致吞咽障碍患者中的应用价值

Application value of ultrasound in patients with dysphagia caused by lateral medullary syndrome

目的 探讨B/M型超声测量对延髓背外侧综合征后吞咽障碍的应用价值。方法 选取存在咽期吞咽障碍,完全依赖管饲进食的延髓背外侧综合征患者20例。于治疗前和治疗后采用经口摄食功能评估量表(FOIS)、视频吞咽障碍分级(VDS)量表中7项咽期评分及超声测量评估患者的吞咽功能。结果 患者治疗前后FOIS评级差异有统计学意义(Z=-3.998,P<0.000)。与治疗前比较,治疗后VDS评分显著降低,颏舌骨肌运动距离、舌骨位移和舌骨-甲状软骨间距离缩短率(ASR)显著升高(均P<0.01)。结论 超声检测颏舌骨肌运动距离、舌骨位移和ASR可以评估延髓背外侧综合征患者舌骨及喉上抬功能的受损情况,间接反映患者治疗前后吞咽功能变化。

Objective To investigate the application value of B/M ultrasonic measurement in patients with dysphagia caused by lateral medullary syndrome.Methods Twenty patients suffered from lateral medullary syndrome with pharyngeal dysphagia and completely depended on tube feeding were selected.Before and after treatment,the swallowing function was evaluated by functional oral intake scale(FOIS),7 pharyngeal indicators in videofluoroscopic dysphagia scale(VDS)and ultrasonic measurement.Results There was significant difference in FOIS rating before and after treatment(Z=-3.998,P<0.000).Compared with those results before treatment,the VDS score was significantly decreased,and the motion amplitude of geniohyoid muscle,hyoid displacement and hyoid-larynx approximation shortening rate(ASR)were significantly increased after treatment(all P<0.01).Conclusion Ultrasound detection of geniohyoid muscle movement distance,hyoid displacement and ASR can evaluate the damage of hyoid and laryngeal lifting function in patients with lateral medullary syndrome,and indirectly reflect the changes in swallowing function before and after treatment.