权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Establishment of therapies for pharyngeal dysphagia-Botulinum toxin injection therapy and functional electrical stimulation-

咽部吞咽困难疗法的建立-肉毒毒素注射疗法和功能性电刺激-

基本信息

批准号：
21500500
负责人：
AOYAGI Yoichiro
金额：
$ 2.83万
依托单位：
Fujita Health University (2011)Kawasaki Medical School (2009-2010)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2009
资助国家：
日本
起止时间：
2009 至 2011
项目状态：
已结题

项目摘要

We evaluated the effectiveness of a cricopharyngeal block using a local anesthetic agent in advance and administered BTX-A injections in various patients with dysphagia. The criteria for this study were : (1) patients with a history of dysphagia who did not improve with conventional swallowing therapy after more than 3 months, (2) oropharyngeal dysphagia in which UES dysfunction appeared to be the primary cause based on videofluorography. A percutaneous lidocaine injection into the cricopharyngeal muscle was first administered in patients who met the above criteria in order to determine the application of BTX-A injections. In cases where the lidocaine injection was judged to improve the passage of bolus in the area of UES using videofluorography, the patients then received a BTX-A injection. Thirty-nine patients met the criteria for the lidocaine injection. The BTX-A injection was done for 28 patients(72%). In 26 patients out of this group(93%), the passage of bolus improved in the area of UES at 1 month after the BTX-A injection. BTX-A is a very effective treatment in selected patients. A local anesthetic agent trial may predict the effectiveness of BTX-A injection.From the viewpoint of functional electric stimulation(FES), we investigated a surface electrode stimulation method to support laryngeal elevation in helthy subjects and patients with pharyngeal dysphagia. Informed consent was obtained from 15 healthy men and 4 patients with pharyngeal dysphagia. Digastric and stylohyoid muscles were stimulated by silver-textile surface electrodes covering the muscle belly. Laryngeal elevation by the electrical stimulation(ES) during liquid(water, 3ml) swallowing movement was measured by digital video camera. Laryngeal elevation by ES was 76% in the healthy subjects and 87% in patients when measured during liquid swallowing. Applying FES for laryngeal elevation may assist in improving the swallowing reflex.

我们评估了使用局部麻醉剂进行颈咽阻滞的有效性，并在各种吞咽困难患者中注射BTX-A。本研究的标准为：（1）有吞咽困难病史且常规吞咽治疗后3个月以上未改善的患者，（2）口咽吞咽困难，其中UES功能障碍似乎是基于视频X线摄影的主要原因。首先对符合上述标准的患者进行经皮利多卡因颈咽肌注射，以确定BTX-A注射的应用。在使用视频荧光造影术判断利多卡因注射可改善UES区域中的推注通过的情况下，患者随后接受BTX-A注射。39例患者符合利多卡因注射标准。28例患者（72%）进行了BTX-A注射。在该组中的26名患者（93%）中，在注射BTX-A后1个月，UES区域的推注通过得到改善。BTX-A在选定的患者中是非常有效的治疗方法。局部麻醉剂试验可以预测BTX-A注射的有效性。我们从功能性电刺激（FES）的观点出发，研究了一种表面电极刺激方法，用于支持健康受试者和咽吞咽困难患者的喉部提升。知情同意书来自15名健康男性和4名咽部吞咽困难患者。通过覆盖肌腹的银织物表面电极刺激二腹肌和茎突舌骨肌。数字摄像机测量吞咽液体（水，3 ml）运动时电刺激（ES）引起的喉抬高。在吞咽液体期间测量时，ES在健康受试者中的喉抬高率为76%，在患者中为87%。应用FES进行喉上举可能有助于改善吞咽反射。