【摘要】：目的：①對比研究咽動態(tài)造影與臨床評估對誤吸檢出率的差別，選擇更準(zhǔn)確的誤吸檢測方法，預(yù)警吸入性肺炎，為診斷、治療提供依據(jù)。②滲透是誤吸的前提條件。通過分析滲透在不同年齡組中的發(fā)生率，初步探討滲透與年齡的關(guān)系。 方法：①收集2012年4月~2013年3月間就診于山西醫(yī)科大學(xué)附屬第一醫(yī)院放射科行消化道造影檢查，經(jīng)詢問病史，，有吞咽功能異常癥狀的患者56例。分別行咽動態(tài)造影檢查和臨床評估。咽動態(tài)造影檢查即使用動態(tài)序列對該組患者的吞咽過程進(jìn)行實(shí)時記錄，觀察到對比劑進(jìn)入聲門以下氣道內(nèi)則記為陽性；臨床評估選用吞水試驗(yàn)，即囑患者一次性喝下30ml水，有嗆咳者記為陽性。比較二者之間誤吸檢出率的差別。②收集同期就診于山西醫(yī)科大學(xué)附屬第一醫(yī)院放射科行消化道檢查，無吞咽障礙癥狀與體征，無神經(jīng)系統(tǒng)疾患、口咽部疾患，無手術(shù)、放療史的患者218例。按年齡是否達(dá)到60歲分為兩組，用咽動態(tài)造影記錄吞咽過程，觀察到對比劑進(jìn)入聲門以上氣道者記為滲透陽性，比較兩組間滲透檢出率的差異。 結(jié)果：①咽動態(tài)造影檢查對誤吸的檢出率高于臨床評估方法，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；②滲透在年齡≥60歲組中的檢出率高于年齡＜60歲組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.01）。 結(jié)論：①咽動態(tài)造影檢查可發(fā)現(xiàn)臨床評估無法檢測出的隱匿性誤吸，直觀顯示誤吸發(fā)生的時相，對預(yù)防吸入性肺炎具有重要價值，對康復(fù)治療具有指導(dǎo)意義，可作為臨床檢測、篩查、評估的重要手段。②滲透在年齡較高人群中發(fā)生率較高，需引起臨床重視。
[Abstract]:Objective to compare the difference between dynamic pharyngography and clinical evaluation in the detection rate of aspiration mis-aspiration, to select more accurate methods for detecting aspiration, to warn aspiration pneumonia, and to provide a basis for diagnosis and treatment with osmotic therapy. By analyzing the incidence of osmosis in different age groups, the relationship between osmosis and age was preliminarily discussed. Methods from April 2012 to March 2013, 56 patients with abnormal swallowing function were examined by digestive tract angiography in radiology department of the first affiliated Hospital of Shanxi Medical University. Pharyngeal dynamic contrast examination and clinical evaluation were performed. Dynamic pharyngography was used to record the swallowing process of the patients in real time, and the contrast agent was recorded as positive in the airway below glottis, and the clinical evaluation was performed by swallowing water test, that is to say, the patients were told to drink 30ml water at one time. Those who have coughing are recorded as positive. To compare the difference of the detection rate of aspiration by mistake between the two groups. 2. At the same time, the department of radiology of the first affiliated Hospital of Shanxi Medical University underwent digestive tract examination, no symptoms and signs of dysphagia, no diseases of nervous system, diseases of oropharynx, and no operation. 218 patients with history of radiotherapy. The patients were divided into two groups according to whether they were 60 years old or not. The swallowing process was recorded by dynamic pharyngiography. The osmotic positive rate was observed when the contrast agent entered the airway above glottis, and the difference of osmotic detection rate between the two groups was compared. Results the detectable rate of false aspiration was higher in the dynamic pharyngeal angiography than in the clinical evaluation method (P < 0.05). The positive rate of osmotic osmosis in the age 鈮

本文編號：2131080