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目的明确脑卒中后吞咽困难在X线透视影像学上的表现及特点。方法对56例脑卒中后吞咽困难患者及30名健康志愿者进行X线电视透视检查,记录异常表现,测量定量参数。统计方法采用秩和检验、t检验、卡方检验及Logistic回归分析。结果脑卒中后所有吞咽器官都表现功能异常,口期吞咽异常者46例,咽期异常者56例。与正常组对照,误吸组喉上抬幅度、速度降低,环咽肌打开宽度减少,吞咽潜伏期延长。34例存在误吸。误吸与舌运动减弱(P=0.021)、舌与硬腭接触不良(P=0.021)、声门关闭不全(P=0.011)、喉上抬慢且幅度降低(P=0.003)、吞咽延迟(P=0.001)及穿透(P=0.000)有关。结论脑卒中可损伤所有参与吞咽的器官,咽期吞咽更易受损,舌肌无力、声门关闭不全、喉结构上抬差及吞咽延迟可造成误吸。
Objective To clarify the manifestations and characteristics of pharyngeal dysphagia in X-ray fluoroscopy. Methods Fifty-six patients with dysphagia after stroke and 30 healthy volunteers were examined by X-ray and the abnormal performance was recorded and the quantitative parameters were measured. Statistical methods using rank sum test, t test, chi-square test and Logistic regression analysis. Results All swallowing organs showed dysfunction after stroke, 46 patients with abnormal oral swallowing and 56 patients with abnormal pharyngeal pharynx. Compared with the normal group, aspiration group laryngeal elevation rate, reduced speed, reduced open width of the cricopharyngeal muscle, pharyngeal swallow latency prolonged. 34 cases of aspiration. (P = 0.021), poor tongue and palate (P = 0.021), incomplete glottis (P = 0.011), slow and slowed laryngeal enlargement (P = 0.003) = 0.001) and penetrating (P = 0.000). Conclusions Stroke can damage all organs involved in swallowing. Pharyngeal swallowing is more vulnerable to swallowing, weakness of the tongue, incomplete glottis closure, poor laryngeal structure and delayed swallowing may lead to aspiration.