食管前性吞咽障碍评估

王剑; 张竹花; 刘建汉; 徐春晓; 杨大海; 霍红; 李五一

doi:10.3969/j.issn.1674-9081.2012.02.007

食管前性吞咽障碍评估

Assessment of Pre-esophageal Dysphagia: Report of 15 Cases

摘要

摘要:
目的探讨食管前性吞咽障碍的评估方法。
方法回顾性分析2001年1月至2011年10月北京协和医院耳鼻咽喉科16例食管前性吞咽障碍患者的临床评估资料。
结果 16例患者中9例接受反复唾液吞咽试验检查均表现异常; 8例接受洼田饮水试验检查均表现为Ⅲ级以上异常; 11例接受吞咽造影检查表现为启动延迟或不能启动, 吞咽相关误吸, 咽腭反流, 食物滞留、残留、渗漏, 环咽肌功能障碍; 11例接受内镜吞咽检查表现为声带麻痹、唾液潴留、咽喉部瘢痕、误吸等异常。
结论反复唾液吞咽试验和洼田饮水试验可作为食管前性吞咽障碍筛查及床旁评价工具, 吞咽造影检查和内镜吞咽检查则可以精确评估吞咽障碍的发生部位及性质, 为下一步治疗提供有力的帮助。

Abstract:
Objective To explore the assessment of pre-esophageal dysphagia.
Methods The data of 16 patients with pre-esophageal dysphagia who were treated in our department from January 2001 to October 2011 were retrospectively analyzed.
Results Of these 16 patients, 9 showed abnormal results during repetitive saliva swallowing test and 8 showed grade Ⅲ or higher abnormalities during Kubota drinking test, 11 patients had abnormal videofluoroscopic swallowing examination results including pooling, residuals, reflex, spillage, penetration, aspiration, and cricopharyngeal disorder. Fibroptic endoscopic evaluation of swallowing showed abnormalities including vocal paralysis, saliva retention, stenosis, and aspiration in 11 patients.
Conclusions Repetitive saliva swallowing test and Kubota drinking test can be applied for screening purpose and as bedside test. Vediofluoroscopic swallowing examination and flexible endoscopic evaluation of swallowing can be used as more accurate assessments.

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