Micklefield G H, Jørgensen E, Blaeser I, Jörg J, Köbberling J
Medizinische Klinik, Ferdinand-Sauerbruch-Klinikum, Wuppertal.
Dtsch Med Wochenschr. 1999 Mar 5;124(9):239-44. doi: 10.1055/s-2007-1024278.
As many as 45% of all strokes can lead to permanent dysphagia, usually considered to be due to abnormal oropharyngeal coordination of contraction. It was the aim of the study to compare oesophageal motility in stroke patients with and without dysphagia.
The study group consisted of 36 patients (13 men, 23 women, mean age 74.1 +/- 11.3 years) who had sustained a stroke (19 [mean age 70.6 +/- 10.5 years] with and 17 [mean age 77.6 +/- 10.5 years] without dysphagia). All these patients underwent oesophageal manometry within 2 days after hospital admission.
There were significant differences in the mean proportion of regular peristaltic waves in the distal oesophagus, 93.5 +/- 1.1% in patients without but in only 53.5 +/- 4.4% of those with dysphagia (P < 0.0001). Measurement of the proximal oesophagus showed 93.2 +/- 3.4% and 62.1 +/- 7.3% respectively. There was no significant difference between these two patient cohorts with regard to the resting pressure in the upper and lower oesophageal sphincters as well as in the amplitude and duration or speed of contraction in the region of the smooth and striated oesophageal muscles.
In patients after a stroke who have dysphagia abnormalities of oesophageal motility are also of importance for their symptoms, being due less to pressure relations than to abnormal contraction patterns.
高达45%的中风患者会导致永久性吞咽困难，通常认为这是由于口咽收缩协调异常所致。本研究旨在比较有吞咽困难和无吞咽困难的中风患者的食管动力。
研究组由36例患者组成（13例男性，23例女性，平均年龄74.1±11.3岁），这些患者均发生了中风（19例[平均年龄70.6±10.5岁]有吞咽困难，17例[平均年龄77.6±10.5岁]无吞咽困难）。所有这些患者在入院后2天内接受了食管测压。
远端食管规则蠕动波的平均比例存在显著差异，无吞咽困难患者为93.5±1.1%，而有吞咽困难患者仅为53.5±4.4%（P<0.0001）。近端食管的测量结果分别为93.2±3.4%和62.1±7.3%。这两组患者在食管上、下括约肌的静息压力以及食管平滑肌和横纹肌区域收缩的幅度、持续时间或速度方面无显著差异。
中风后有吞咽困难的患者，食管动力异常对其症状也很重要，其原因与其说是压力关系，不如说是异常的收缩模式。
