Kendall K A, Leonard R J
Department of Otolaryngology, University of California, Davis Medical Center, Sacramento 95817, USA.
Dysphagia. 2001 Fall;16(4):272-8. doi: 10.1007/s00455-001-0086-4.
This article reports the results of our study to determine the incidence of abnormalities in timing and extent of pharyngeal constriction in an elderly population with complaints of dysphagia. We performed a retrospective analysis of videofluoroscopic studies, i.e.. dynamic swallow studies, that were performed between 1996 and 1999. Included in the study were patients over 65 years old without an obvious medical or surgical cause for their dysphagia complaints. The timing of maximum pharyngeal constriction was measured relative to the onset of bolus pharyngeal transit, relative to the arrival of the bolus at the upper esophageal sphincter, and relative to the exit of the tail of the bolus from the upper esophageal sphincter. The extent of maximum pharyngeal constriction was measured from a lateral view. Patient data were compared with data gathered from young (18-62 years old) nondysphagic controls and with data gathered from elderly (67-83 years old) nondysphagic controls. We found that 73% of the patient population demonstrated incomplete pharyngeal constriction relative to controls, although the timing of pharyngeal constriction remained coordinated relative to the position of the bolus in the pharynx. Poor pharyngeal constriction, suggestive of pharyngeal weakness, contributed to 75% of the cases of aspiration.
本文报告了我们的一项研究结果，该研究旨在确定有吞咽困难主诉的老年人群中咽缩窄在时间和程度上异常的发生率。我们对1996年至1999年间进行的视频荧光透视研究（即动态吞咽研究）进行了回顾性分析。纳入研究的是65岁以上且吞咽困难主诉无明显内科或外科病因的患者。最大咽缩窄的时间是相对于食团进入咽部的起始时间、相对于食团到达食管上括约肌的时间以及相对于食团尾部从食管上括约肌排出的时间来测量的。最大咽缩窄的程度是从侧位观察测量的。将患者数据与从年轻（18 - 62岁）无吞咽困难的对照组以及从老年（67 - 83岁）无吞咽困难的对照组收集的数据进行比较。我们发现，相对于对照组，73%的患者人群表现出不完全咽缩窄，尽管咽缩窄的时间相对于食团在咽部的位置仍保持协调。提示咽肌无力的咽缩窄不佳导致了75%的误吸病例。
