CT引导下肉毒毒素环咽肌注射治疗真性延髓麻痹所致吞咽障碍1例报道
|
摘要
目的探讨CT引导下肉毒毒素环咽肌注射治疗1例真性延髓麻痹所致吞咽障碍患者的效果。方法回顾1例真性延髓麻痹所致吞咽障碍患者的临床资料,采用CT引导进行肉毒毒素环咽肌注射。结果患者脑干梗死后出现吞咽障碍,诊断为真性延髓麻痹。予以吞咽障碍常规康复治疗及球囊扩张术,临床效果良好,因患者病情反复3次,予以CT引导下肉毒毒素环咽肌注射,临床疗效显著,随访未再出现病情反复。结论 CT引导下肉毒毒素环咽肌注射治疗真性延髓麻痹所致吞咽障碍临床疗效显著,出现病情反复可能性小。
Objective To explore the effect of CT-guided Botulinum toxin injection into cricopharynx muscle on dysphagia caused by true bulbar palsy.Methods A case of dysphagia caused by true bulbar palsy was treated with CT-guided Botulinum toxin injection and its therapeutic effect was reported.Results The patient had dysphagia after brainstem infarction and was diagnosed as true bulbar palsy. After routine rehabilitation of dysphagia and balloon dilatation, her dysphagia relieved, but reappeared three times. Botulinum toxin was injected into the loop pharynx muscle under the guidance of CT, the clinical effect was remarkable, and no recurrence of the disease appeared in the follow-up.Conclusion CT-guided Botulinum toxin injection into cricopharyngeus is effective on dysphagia caused by true medullary palsy, and the probability of recurrence is small.
Objective To explore the effect of CT-guided Botulinum toxin injection into cricopharynx muscle on dysphagia caused by true bulbar palsy.Methods A case of dysphagia caused by true bulbar palsy was treated with CT-guided Botulinum toxin injection and its therapeutic effect was reported.Results The patient had dysphagia after brainstem infarction and was diagnosed as true bulbar palsy. After routine rehabilitation of dysphagia and balloon dilatation, her dysphagia relieved, but reappeared three times. Botulinum toxin was injected into the loop pharynx muscle under the guidance of CT, the clinical effect was remarkable, and no recurrence of the disease appeared in the follow-up.Conclusion CT-guided Botulinum toxin injection into cricopharyngeus is effective on dysphagia caused by true medullary palsy, and the probability of recurrence is small.
引文
[1]高金立.延髓麻痹吞咽障碍的神经机理与临床诊断[J].哈尔滨医药2014,34(2):120,122.
[2]刘贤秀,姜艳平.脑梗死急性期吞咽障碍康复治疗的疗效观察[J].中华临床医师杂志(电子版),2012,6(23):7799-7801.
[3]马艳平,宋成忠,岳寿伟,等.脑卒中后真性延髓麻痹吞咽障碍的综合治疗[J].中国康复医学杂志,2010,25(2):165-166.
[4]窦祖林.吞咽障碍评估与治疗[M].北京:人民卫生出版社,2009:43-63.
[5]朱海霞,李一贤,张琰,等.球囊扩张术对脑卒中后吞咽障碍康复疗效及不良并发症研究[J].中国康复,2018,33(4):275-278.
[6]朱榕,张莉,杨平,等.导尿管球囊扩张术对神经源性环咽肌失迟缓症治疗效果的Meta分析[J].中国康复医学杂志,2018,33(5):573-577.
[7]黄晓煌,白伟杰,凌水桥,等.导尿管球囊扩张术对治疗脑卒中后环咽肌失弛缓症的疗效分析[J].临床和实验医学杂志,2017,16(12):1215-1218.
[8]兰晓燕,白艳杰.导尿管球囊扩张术治疗神经源性环咽肌失弛缓症的疗效观察[J].中国实用神经疾病杂志,2016,19(24):114-115.
[9]宋艳平.脑卒中患者经鼻及口行球囊扩张术治疗环咽肌失弛缓症的疗效[J].中国实用神经疾病杂志,2014,17(17):124-125.
[10]黄绍春,杨永超,刘莉,等.主动球囊扩张术治疗卒中后环咽肌失弛缓所致吞咽障碍的效果[J].中国脑血管病杂志,2016,13:398-403.
[11]魏新侠,马赛超,胡玉侠.导管球囊扩张术在吞咽障碍治疗中的疗效分析[J].临床医药文献杂志,2016,3(22):4357-4358.
[12]张百祥,华何柳,王秀玲,等.导尿管球囊扩张术对神经源性环咽肌失弛缓症所致吞咽障碍的疗效观察[J].中国医药指南,2016,14(34):8-10.
[13]Katon J,Hayakawa M,Ishihara K,et al.Swallowing rehabilitation using balloon catheter treatment evaluated by videofluorography in an early patient with Wallenberg syndrome[J].Nippon Ronen Igakkai Zasshi,2000,37(6):490-494.
[14]鲁谨,张晶晶,席艳玲,等.导尿管球囊扩张术在老年神经源性环咽肌失弛缓症患者中的应用[J].中华物理医学与康复杂志,2012,34(10):779-780.
[15]岳寿伟,怀娟,关家文,等.食管球囊造影联合CT引导下环咽肌肉毒毒素注射治疗脑干损伤后吞咽障碍1例报告[J].中国康复医学杂志2017,32(9):1046-1048.
[16]Woisard-Bassols V,Alshehri S,Simonetta-Moreau M.The effects of Botulinum toxin injections into the cricopharyngeus muscle of patients with cricopharyngeus dysfunction associated with pharyngo-laryngeal weakness[J].Eur Arch Otorhinolaryngol,2013,270(3):805-815.
[17]Kim M S,Kim G W,Rho Y S,et al.Office-based electromyographyguided Botulinum toxin injection to the cricopharyngeus muscle:optimal patient selection and technique[J].Ann Otol Rhinol Laryngol2017,126(5):349-356.
[18]林晓婷,杨海云,栗晓,等.超声引导肉毒毒素注射治疗环咽肌功能障碍探讨[J].中山大学学报(医学版),2018,39(3):472-476.
[19]窦祖林.吞咽障碍评估与治疗[M].2版.北京:人民卫生出版社2017.
[20]兰月,窦祖林,万桂芳,等.球囊扩张术治疗脑干病变后环咽肌失弛缓症的疗效研究[J].中华物理医学与康复杂志,2009,31(12):835-838.
[21]Wang Y,Lim L L,Heller R F,et al.A prediction model of 1-year mortality for acute ischemic stroke patients[J].Arch Phys Med Rehabil,2003,84(7):1006-1011.
[22]Wade D T,Hewer R L.Motor loss and swallowing difficulty after stroke:frequency,recovery,and prognosis[J].Acta Neurol Scand1987,76:50-54.
[23]Kelly E A,Koszewski I J,Jaradeh S S.Botulinum toxin injection for the treatment of upper esophageal sphincter dysfunction[J].Ann Oto Rhinol Laryn,2013,122(2):100-108.
[24]Alfonsi E,Restivo D A,Cosentino G.Botulinum toxin is effective in the management of neurogenic dysphagia.Clinical-electrophysiological findings and tips on safety in different neurological disorders[J]Front Pharmacol,2017,8(5886):80-90.
[25]Terre R,Vallès M,Panadés A,et al.Long-lasting effect of a single Botulinum toxin injection in the treatment of oropharyngeal dysphagia secondary to upper esophageal sphincter dysfunction:a pilot study[J]Scand J Gastroenterol,2008,43(11):1296-1303.
[26]万桂芳,窦祖林,兰月,等.球囊扩张术中球囊容积与吞咽功能恢复的相关性分析[J].中华物理医学与康复杂志,2009,31(12):820-822.
[27]郭钢花,李哲,关晨霞,等.不同方式球囊扩张治疗环咽肌失迟缓症的疗效分析[J].中华物理医学与康复杂志,2011,33(12):909-911.
[2]刘贤秀,姜艳平.脑梗死急性期吞咽障碍康复治疗的疗效观察[J].中华临床医师杂志(电子版),2012,6(23):7799-7801.
[3]马艳平,宋成忠,岳寿伟,等.脑卒中后真性延髓麻痹吞咽障碍的综合治疗[J].中国康复医学杂志,2010,25(2):165-166.
[4]窦祖林.吞咽障碍评估与治疗[M].北京:人民卫生出版社,2009:43-63.
[5]朱海霞,李一贤,张琰,等.球囊扩张术对脑卒中后吞咽障碍康复疗效及不良并发症研究[J].中国康复,2018,33(4):275-278.
[6]朱榕,张莉,杨平,等.导尿管球囊扩张术对神经源性环咽肌失迟缓症治疗效果的Meta分析[J].中国康复医学杂志,2018,33(5):573-577.
[7]黄晓煌,白伟杰,凌水桥,等.导尿管球囊扩张术对治疗脑卒中后环咽肌失弛缓症的疗效分析[J].临床和实验医学杂志,2017,16(12):1215-1218.
[8]兰晓燕,白艳杰.导尿管球囊扩张术治疗神经源性环咽肌失弛缓症的疗效观察[J].中国实用神经疾病杂志,2016,19(24):114-115.
[9]宋艳平.脑卒中患者经鼻及口行球囊扩张术治疗环咽肌失弛缓症的疗效[J].中国实用神经疾病杂志,2014,17(17):124-125.
[10]黄绍春,杨永超,刘莉,等.主动球囊扩张术治疗卒中后环咽肌失弛缓所致吞咽障碍的效果[J].中国脑血管病杂志,2016,13:398-403.
[11]魏新侠,马赛超,胡玉侠.导管球囊扩张术在吞咽障碍治疗中的疗效分析[J].临床医药文献杂志,2016,3(22):4357-4358.
[12]张百祥,华何柳,王秀玲,等.导尿管球囊扩张术对神经源性环咽肌失弛缓症所致吞咽障碍的疗效观察[J].中国医药指南,2016,14(34):8-10.
[13]Katon J,Hayakawa M,Ishihara K,et al.Swallowing rehabilitation using balloon catheter treatment evaluated by videofluorography in an early patient with Wallenberg syndrome[J].Nippon Ronen Igakkai Zasshi,2000,37(6):490-494.
[14]鲁谨,张晶晶,席艳玲,等.导尿管球囊扩张术在老年神经源性环咽肌失弛缓症患者中的应用[J].中华物理医学与康复杂志,2012,34(10):779-780.
[15]岳寿伟,怀娟,关家文,等.食管球囊造影联合CT引导下环咽肌肉毒毒素注射治疗脑干损伤后吞咽障碍1例报告[J].中国康复医学杂志2017,32(9):1046-1048.
[16]Woisard-Bassols V,Alshehri S,Simonetta-Moreau M.The effects of Botulinum toxin injections into the cricopharyngeus muscle of patients with cricopharyngeus dysfunction associated with pharyngo-laryngeal weakness[J].Eur Arch Otorhinolaryngol,2013,270(3):805-815.
[17]Kim M S,Kim G W,Rho Y S,et al.Office-based electromyographyguided Botulinum toxin injection to the cricopharyngeus muscle:optimal patient selection and technique[J].Ann Otol Rhinol Laryngol2017,126(5):349-356.
[18]林晓婷,杨海云,栗晓,等.超声引导肉毒毒素注射治疗环咽肌功能障碍探讨[J].中山大学学报(医学版),2018,39(3):472-476.
[19]窦祖林.吞咽障碍评估与治疗[M].2版.北京:人民卫生出版社2017.
[20]兰月,窦祖林,万桂芳,等.球囊扩张术治疗脑干病变后环咽肌失弛缓症的疗效研究[J].中华物理医学与康复杂志,2009,31(12):835-838.
[21]Wang Y,Lim L L,Heller R F,et al.A prediction model of 1-year mortality for acute ischemic stroke patients[J].Arch Phys Med Rehabil,2003,84(7):1006-1011.
[22]Wade D T,Hewer R L.Motor loss and swallowing difficulty after stroke:frequency,recovery,and prognosis[J].Acta Neurol Scand1987,76:50-54.
[23]Kelly E A,Koszewski I J,Jaradeh S S.Botulinum toxin injection for the treatment of upper esophageal sphincter dysfunction[J].Ann Oto Rhinol Laryn,2013,122(2):100-108.
[24]Alfonsi E,Restivo D A,Cosentino G.Botulinum toxin is effective in the management of neurogenic dysphagia.Clinical-electrophysiological findings and tips on safety in different neurological disorders[J]Front Pharmacol,2017,8(5886):80-90.
[25]Terre R,Vallès M,Panadés A,et al.Long-lasting effect of a single Botulinum toxin injection in the treatment of oropharyngeal dysphagia secondary to upper esophageal sphincter dysfunction:a pilot study[J]Scand J Gastroenterol,2008,43(11):1296-1303.
[26]万桂芳,窦祖林,兰月,等.球囊扩张术中球囊容积与吞咽功能恢复的相关性分析[J].中华物理医学与康复杂志,2009,31(12):820-822.
[27]郭钢花,李哲,关晨霞,等.不同方式球囊扩张治疗环咽肌失迟缓症的疗效分析[J].中华物理医学与康复杂志,2011,33(12):909-911.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |