【摘要】 目的通过分析吞咽障碍的高龄患者改良吞钡造影检查影像学特征,探讨高龄吞咽障碍患者误吸的相关危险因素。方法选择高龄吞咽障碍患者68例,进行床旁临床评定以及改良吞钡造影检查,采用分区法将成像过程分成A、B、C和D区,分析患者误吸的相关危险因素。结果改良吞钡造影检查结果显示,吞咽障碍主要表现在A、B、C区,多数患者舌肌运送能力减弱,舌肌萎陷,舌腭连接不良占88.2%,食团提前后漏占83.8%,口腔运送时间延长占72.1%,咽启动延迟占80.9%,会厌谷残留占79.4%,喉渗透占72.1%。logistic回归分析结果显示,吞咽启动延迟(OR=13.291,95%CI:2.300~76.797,P=0.033)、会厌谷残留(OR=13.163,95%CI:2.215~78.231,P=0.004)、喉渗透(OR=3.765,95%CI:0.728~19.475,P=0.005)是导致高龄吞咽障碍患者误吸的相关危险因素。结论高龄吞咽障碍患者具有特征的影像学表现。治疗师、康复医师应根据患者改良吞钡造影检查影像学资料,客观地评价患者情况,制订合理、科学地康复计划,减少误吸发生。更多还原

【Abstract】 Objective To study the risk factors for swallowing in advance-aged dysphagia patients by analyzing their imaging features of modified barium swallow imaging examination.MethodsSixty-eight advance-aged dysphagia patients underwent modified barium swallow imaging examination.The imaging process was divided into A,B,C,D four zones and swallowing-related risk factors were analyzed.Results In most patients,the conveying function of linguales was decreased and linguales were getting shrunk.The incidence of inadequate tougue-palate contact,premature bonus loss,prolonged oral transport time,delayed pharyngeal triggering time,epiglottic vallecula resdue,and laryngeal penetration accounted for 88.2%,83.8%,72.1%,80.9%,79.4%,and 72.1%,respectively.Multivariate logistic regression analysis showed that delayed pharyngeal triggering time,epiglottic vallecula resdue,and laryngeal penetration were the risk factors for swallowing in advance-aged dysphagia patients(OR=13.291,95%CI:2.300-76.797,P=0.033;OR=13.163,95%CI:2.215-78.231,P=0.004;OR=3.765,95%CI:0.728-19.475,P=0.005).Conclusion Advance-aged dysphagia patients are of their characteristic imaging features.Therapists and rehabilitation physicians should work out their rational and scientific rehabilitation program according to the objective assessment of their condition and modified barium swallow imaging examination data in oreder to reduce the risk factors for swallowing.更多还原