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帕金森病吞咽功能的电视荧光造影研究。

Videofluorographic study of swallowing in Parkinson's disease.

作者信息

Nagaya M, Kachi T, Yamada T, Igata A

机构信息

Department of Rehabilitation, Chubu National Hospital, Obu, Japan.

出版信息

Dysphagia. 1998 Spring;13(2):95-100. doi: 10.1007/PL00009562.

Abstract

We studied 16 patients with Parkinson's disease (PD) with dysphagia and 8 young and 7 elderly normal controls videofluorographically to evaluate the nature of swallowing disorders in PD patients. In 13 patients, abnormal findings in the oral phase were residue on the tongue or residue in the anterior and lateral sulci, repeated pumping tongue motion, uncontrolled bolus or premature loss of liquid, and piecemeal deglutition. Thirteen patients showed abnormal findings in the pharyngeal phase, including vallecular residue after swallow, residue in pyriform sinuses, and delayed onset of laryngeal elevation. Ten of these patients also showed abnormal findings in both the oral and pharyngeal phases. Aspiration was seen in 9 patients. The oral transit duration was significantly longer in the patients with and without aspiration than in the control subjects. The stage transition duration, pharyngeal transit duration, duration of the upper esophageal sphincter (UES) opening, and total swallow duration were significantly longer in the patients with and without aspiration than in the young controls, but were not longer than in the elderly controls. These durational changes in the pharyngeal phase of swallowing were similar to those in the elderly controls. The findings suggest that the disturbed motility in the oral phase of swallowing may be due to bradykinesia. Although PD patients with dysphagia evince a variety of swallowing abnormalities, the duration of pharyngeal swallowing may remain within the age-related range until the symptoms worsen.

摘要

我们对16例患有吞咽困难的帕金森病(PD)患者以及8名年轻和7名老年正常对照者进行了视频荧光吞咽造影检查,以评估PD患者吞咽障碍的性质。在13例患者中,口腔期的异常表现包括舌面残留、前后侧沟残留、反复的舌部抽动动作、食团控制不佳或液体过早流失以及分次吞咽。13例患者在咽期出现异常表现,包括吞咽后会厌谷残留、梨状窦残留以及喉提升延迟。其中10例患者在口腔期和咽期均出现异常表现。9例患者出现误吸。有和没有误吸的患者的口腔通过时间均显著长于对照受试者。有和没有误吸的患者的阶段转换时间、咽通过时间、上食管括约肌(UES)开放时间以及总吞咽时间均显著长于年轻对照者,但不超过老年对照者。吞咽咽期的这些时间变化与老年对照者相似。这些发现表明,吞咽口腔期的运动障碍可能是由于运动迟缓所致。尽管患有吞咽困难的PD患者表现出多种吞咽异常,但在症状恶化之前,咽吞咽时间可能仍保持在与年龄相关的范围内。

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