一种吞咽障碍压力测定治疗仪的设计与临床初步研究

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

Keywords:cricopharyngeal achalasia  pressure measurement  expansion treatment  dysplasia  vedeofluoroscopic swallowing study

摘要：

      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。

Abstract:

      Abstract Objective: For the sake of pharyngeal dysphagia cricopharyngeal achalasia(CA) pressure measurement and quantitative 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 latter was located in the middle of the formers. The middle balloon could be compressed for measuring the cricopharyngeal 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 swallowing study(VFSS) showed CA and high cricopharyngeal muscle pressure. The patient was treated by balloon dilation for 5 days; after treatment the clinical symptoms improved significantly, Kubota water test was down toⅠlevel, VFSS showed almost normal, the pressure of cricopharyngeal muscle decreased obviously. In the subject with normal swallowing, Kubota water test was at Ⅰ level; VFSS showed the pressure of cricopharyngeal muscle was lower than the patient with CA. Conclusion: This wallowing disorder pressure measurement and treatment equipment is reliable，noninvasive and inexpensive. The procedure can be easily handled by clinicians, maybe cause the subject minimum discomfort only, but no side effect. It has better clinical practical value.