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| 延髓梗死后环咽肌功能障碍的发病机制与康复治疗研究进展 |
| Advances in rehabilitationmanagement of cricopharyngeal muscle dysfunction Following medullary infarction：A Review |
| 投稿时间：2026-06-24 修订日期：2026-08-04 |
| DOI： |
| 中文关键词: 延髓梗死 环咽肌功能障碍 吞咽障碍 康复治疗 |
| 英文关键词: Medullary Infarction,Cricopharyngeal Dysfunction,Dysphagia,Rehabilitation Therapy |
| 基金项目: |
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| 摘要点击次数: 39 |
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| 中文摘要: |
| 吞咽生理过程分为口腔期、咽期、食管期,不同分期的临床表现与脑损伤区域直接相关。环咽肌功能障碍是延髓梗死后咽期吞咽障碍的核心病理机制,特点为进食时口腔功能无明显异常,但吞咽时呛咳或咽部梗阻感,食物无法通过咽部进入食道。吞咽造影可观察到环咽肌开放不全或完全不开放,伴会厌谷与梨状隐窝残留。当前针对环咽肌功能障碍的治疗包括靶向肌群训练如Shaker训练、下颌抗阻训练,舌压抗阻训练等,器械干预如导管球囊扩张术、侵入性操作技术如环咽肌A型肉毒毒素注射术、以及神经调控技术如重复经颅磁刺激,传统中医治疗如针刺治疗等。本文旨在系统综述延髓梗死所致环咽肌功能障碍的康复干预进展,为优化临床诊疗路径提供依据。 |
| 英文摘要: |
| The physiological process of swallowing is divided into oral phase, pharyngeal phase and esophageal phase. The clinical manifestations of different stages are directly related to the area of brain injury. Circumpharyngeal muscle dysfunction is the core pathological mechanism of pharyngeal dysphagia after medullary infarction. It is characterized by no obvious abnormality of oral function during eating, but choking cough or pharyngeal obstruction during swallowing, and food cannot enter the esophagus through the pharynx. Swallowing angiography can observe incomplete opening or complete non-opening of the cricopharyngeal muscle, accompanied by epiglottic valley and piriform recess residue. At present, the treatment of cricopharyngeal dysfunction includes targeted muscle group training such as Shaker training, chin tuck against resistance,Tongue ressure resistance training,instrument intervention such as catheter balloon dilatation, invasive operation techniques such as botulinum toxin type A injection of cricopharyngeal muscle, and neuromodulation techniques such as repetitive transcranial magnetic stimulation. The purpose of this paper is to systematically review the progress of frontier rehabilitation interventions for cricopharyngeal dysfunction caused by medullary infarction, and to provide evidence-based basis for optimizing clinical diagnosis and treatment pathways. |
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