Veis S L, Logemann J A
Arch Phys Med Rehabil. 1985 Jun;66(6):372-5.
Thirty-eight CVA patients with swallowing disorders were studied videofluorographically (VFG) to determine: (1) the nature of their swallowing disorders, (2) the relationship between the site of the cerebrovascular accident and the nature of the swallowing disorder(s) exhibited and (3) the frequency and etiology of any aspiration present. The 38 CVA patients exhibited a variety of physiologic disturbances in swallowing, usually occurring in combination rather than as isolated disorders. A delayed swallowing reflex was the most frequent disorder seen in all patient groups. Reduced pharyngeal peristalsis was the next most frequent disorder, followed by reduced tongue control. Only brainstem CVA patients exhibited reduced laryngeal closure. Two patients (no right CVAs) experienced cricopharyngeal dysfunction. Few differences in nature of swallowing disorders were seen according to lesion location. Approximately one third of the patients aspirated, most frequently because of delayed triggering of the swallowing reflex. All aspiration occurred because of disorders in the pharyngeal stage of the swallow, emphasizing the importance of VFG evaluation of dysphagia in CVA patients.
对38例患有吞咽障碍的脑血管意外（CVA）患者进行了电视荧光吞咽造影（VFG）研究，以确定：（1）他们吞咽障碍的性质；（2）脑血管意外发生部位与所表现出的吞咽障碍性质之间的关系；以及（3）任何误吸的频率和病因。这38例CVA患者在吞咽过程中表现出多种生理紊乱，通常是合并出现而非单独出现。吞咽反射延迟是所有患者组中最常见的障碍。咽部蠕动减弱是其次最常见的障碍，其次是舌控制能力下降。只有脑干CVA患者表现出喉关闭不全。两名患者（无右侧CVA患者）出现环咽肌功能障碍。根据病变部位，吞咽障碍的性质几乎没有差异。约三分之一的患者发生误吸，最常见的原因是吞咽反射触发延迟。所有误吸均发生在吞咽的咽部阶段，强调了VFG评估CVA患者吞咽困难的重要性。
