Kumai Yoshihiko, Samejima Yasuhiro, Yumoto Eiji
Department of Otolaryngology, Head & Neck Surgery Graduate School of Medicine, Kumamoto University, Kumamoto.
Nihon Jibiinkoka Gakkai Kaiho. 2004 Jan;107(1):7-11. doi: 10.3950/jibiinkoka.107.7.
We evaluated videofluorographic recordings of the pharynx (VF) in patients suffering from aspiration pneumonia. The patients consisted of 55 men and 6 women who consulted the ENT Department at Kumamoto University Hospital between May 1994 and February 2002. Surgery for an upper alimentary tract malignancy (16 patients) was the most frequent background feature. The number of patients with cerebrovasucular disease and neuronal/neuromuscular diseases were 11 and 12, respectively. VF enabled the misswallowing of barium into the trachea to be visualized in 38 patients. Of these 38 patients, 20 exhibited misswallowing during or after the pharyngeal stage of swallowing. Among the 23 patients in whom misswallowing was not detected, 13 had upper alimentary tract diseases. The VF findings suggested the presence of gastroesophageal clearance after swallowing. Gastro-esophageal regurgitation may be a significant factor, in addition to the silent aspiration of oral and pharyngeal secretions during the night as a trigger of recurrent aspiration pneumonia.
我们评估了患有吸入性肺炎患者的咽部视频荧光造影记录（VF）。患者包括1994年5月至2002年2月间到熊本大学医院耳鼻喉科就诊的55名男性和6名女性。上消化道恶性肿瘤手术（16例患者）是最常见的背景特征。脑血管疾病患者和神经/神经肌肉疾病患者分别为11例和12例。VF可观察到38例患者钡剂误咽入气管。在这38例患者中，20例在吞咽的咽部阶段期间或之后出现误咽。在未检测到误咽的23例患者中，13例患有上消化道疾病。VF结果提示吞咽后存在胃食管清除。除了夜间口腔和咽部分泌物的隐性吸入作为复发性吸入性肺炎的触发因素外，胃食管反流可能是一个重要因素。
