Jamrozik Z, Czyzewski K, Zakrzewska-Pniewska B, Kwieciński H
Klinika Neurologiczna, Akademii Medycznej w Warszawie.
Neurol Neurochir Pol. 1999 Nov-Dec;33(6):1435-41.
We described a 47-year-old man with ischemic stroke who developed a brainstem syndrome with persistent dysphagia. He was fed by the nasogastric tube placed intermittently by himself for almost 7 months after the stroke. Elective feeding via percutaneous endoscopic gastrostomy (PEG) was not accepted by the patient. All treatment attempts with benzodiazepines, antidepressants and spasmolytic agents were unsuccessful. Videofluoroscopic investigation revealed excessive and long-lasting spasm of the upper esophageal sphincter which was associated with the massive aspiration of the contrast. The patient dramatically improved after treatment with nitroglycerin and long-acting nitrates with almost complete recovery of normal swallowing. A strikingly good effect of nitrates in the treatment of oropharyngeal dysphagia is emphasized by the authors.
我们描述了一名47岁的缺血性中风男性患者，他出现了伴有持续性吞咽困难的脑干综合征。中风后近7个月，他一直自行间断放置鼻胃管进食。患者不接受经皮内镜下胃造口术（PEG）择期喂养。使用苯二氮䓬类药物、抗抑郁药和解痉药的所有治疗尝试均未成功。电视荧光透视检查显示食管上括约肌过度且持久的痉挛，这与造影剂的大量误吸有关。患者在接受硝酸甘油和长效硝酸盐治疗后显著改善，吞咽功能几乎完全恢复正常。作者强调了硝酸盐在治疗口咽性吞咽困难方面的显著良好效果。
