Chen M Y, Peele V N, Donati D, Ott D J, Donofrio P D, Gelfand D W
Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1088.
Gastrointest Radiol. 1992 Spring;17(2):95-8. doi: 10.1007/BF01888518.
Forty-one patients with neurologic disease (ND) were evaluated by clinical and videofluoroscopic examination of the oral cavity and pharynx to assess location and severity of swallowing dysfunction using various bolus consistencies. Four different materials were given to each patient, and included low- and high-viscosity barium suspensions, barium paste, and paste-coated cookie. Thirty-five patients had abnormalities of both oral and pharyngeal function. Four patients had pharyngeal dysfunction only, and two patients were normal. Mild swallowing difficulties occurred in five patients (12%), moderate dysfunction in 29 patients (71%), and severe dysfunction in five patients (12%). Thirty-two patients had pharyngeal stasis, which was symmetric in 30 patients (94%) and asymmetric in two. Site of stasis was not related to the type of neurologic disease. Fifteen patients aspirated, most of them (13 of 15) with the low-viscosity barium suspension. The predominance of aspiration with the low-viscosity liquid emphasizes the importance of clinical and videofluoroscopic evaluation of swallowing in dysphagic patients with ND for appropriate feeding recommendations. Thus, videofluoroscopy complemented the clinical examination and defined the type and severity of swallowing abnormalities and aspiration, when present.
对41例神经系统疾病（ND）患者进行了口腔和咽部的临床及视频透视检查，以评估使用不同团块稠度时吞咽功能障碍的部位和严重程度。给每位患者使用四种不同的材料，包括低粘度和高粘度钡剂混悬液、钡糊以及涂有糊剂的饼干。35例患者存在口腔和咽部功能异常。4例患者仅存在咽部功能障碍，2例患者正常。5例患者（12%）出现轻度吞咽困难，29例患者（71%）出现中度功能障碍，5例患者（12%）出现重度功能障碍。32例患者存在咽部淤滞，其中30例患者（94%）为对称性，2例为不对称性。淤滞部位与神经系统疾病类型无关。15例患者发生误吸，其中大多数（15例中的13例）是在使用低粘度钡剂混悬液时发生的。低粘度液体导致的误吸占优势，这强调了对患有ND的吞咽困难患者进行临床和视频透视吞咽评估以提供适当喂养建议的重要性。因此，视频透视检查补充了临床检查，并确定了吞咽异常和误吸（如有）的类型和严重程度。
