一种吞咽障碍压力测定治疗仪的设计与临床初步研究-中国康复医学杂志.PDF

2013年，第28卷，第8期 ·临床研究· 一种吞咽障碍压力测定治疗仪的设计与 临床初步研究* 1 1 2，3 1 冯 珍 帅 浪 张 纯 刘玲玲 摘要 目的：针对咽期吞咽障碍环咽肌失弛缓的压力测量和定量扩张问题，设计开发吞咽障碍压力测定治疗仪并予以临床 初步研究。 方法：该装置的导管和膨胀气囊部分以导尿管结构为蓝本，选择硅胶作为气囊材料，制成三个独立气囊，上下两个气 囊为定位气囊，通过中间气囊对环咽肌张力进行测量及垂直定向加压扩张。将之应用于两名受试者（环咽肌失弛缓 患者1例和吞咽正常受试者1例）。 结果：环咽肌失弛缓患者治疗前洼田饮水试验Ⅴ级，吞咽造影检查示环咽肌失弛缓，环咽肌压力值高；患者行扩张治 疗5d 后其临床症状明显好转, 洼田饮水试验降至Ⅰ级，吞咽造影检查基本正常，环咽肌压力值明显下降。吞咽正常 受试者洼田饮水试验Ⅰ级，吞咽造影检查示环咽肌正常，环咽肌压力值较环咽肌失弛缓患者低。 结论：该吞咽障碍压力测定治疗仪数据测量简单可靠，患者无明显不良反应，医疗成本低，有较强的临床实用性。 关键词 环咽肌失弛缓；压力测量；扩张治疗；吞咽障碍；吞咽造影检查 中图分类号：R493 文献标识码：A 文章编号：1001-1242(2013)-08-0723-04 The design and clinical preliminary study ：A swallowing disorder pressure measurement and treatment equipment/FENG Zhen,SHUAI Lang,ZHANG Chun,et al.//Chinese Journal of Rehabilitation Medicine ， 2013 ，28 （8 ）：723—726 Abstract Objective: For the sake of pharyngeal dysphagia cricopharyngeal achalasia(CA) pressure measurement and quan- titative expansion, to design and develop a swallowing disorder pressure measurement and treatment equipment. Method: The equipment consisted of two parts: catheter and inflation balloon, which was made of silicagel, and made into three separated balloons, including two positioning balloons and one expanding balloon. The lat- ter was located in the middle of the formers. The middle balloon could be compressed for measuring the crico- pharyngeal muscle tension and expanding in vertical orientation. This technology was applied to two subjects （1 patient with CA and 1 subject with normal swallowing）. Result:Before treatment, in the patient with CA Kubota water test was at Ⅴ level; vedeofluoroscopic swallow- ing study(VFSS) showed CA and high cricopharyngeal muscle pressure. The patient