嚥下造影検査後の消化器合併症および消化管内バリウム残留の検討

Gastrointestinal Complications and Intestinal Stasis after Videofluoroscopic Examination of Swallowing

要旨：嚥下造影検査後に生じる消化器合併症および消化管内のバリウム残留について検討した．2008年10月から2009年3月，9月から10月に当院にて嚥下造影を施行した入院患者121名のうち，4日後に腹部単純X線を撮影しえた33例を対象とした．消化器症状は33例中6例（18.2％）に認めた．内訳は下痢3例，嘔吐2例，腹部膨満感1例であった．そのうち，嚥下造影との関連が疑われるものは2例であり，嚥下造影後の消化器合併症は6.1％と推定された．2例のうち1例は全身状態不良例であり嘔吐後に肺炎を併発した．合併症発現と有意に関連する因子は認めなかった．腹部単純X線でのバリウムの残留は25例（75.8％）に認めた．残留群では非残留群よりバリウム摂取量が有意に多かった．残留と消化器合併症発現との関連は認められなかった．嚥下造影は全身状態不良例での施行には注意を要するが，その他の症例では安全に施行可能である．

Abstract : The purpose of this study was to investigate the occurrence of gastrointestinal complications and intestinal stasis after a videofluoroscopic examination of swallowing. Of 121 inpatients who underwent videofluoroscopic examinations from October 2008 to March 2009 and September to October 2009, we analyzed 33 patients who underwent abdominal X-ray four days after their videofluoroscopic examination. Six of 33 patients (18.2％) suffered gastrointestinal symptoms. Three patients had diarrhea, two had vomiting, and one had abdominal distention. The incidence of gastrointestinal complications after videofluoroscopic examination was estimated to be two of 33 patients (6.1％) because we assumed that two of the six patients' condition was related to their videofluoroscopic examination and that the other four were related to other factors. One of two patients with a poor general condition developed pneumonia after vomiting. There was no relationship between the incidence of gastrointestinal complications and the patient's background. Intestinal stasis as detected by X-ray was identified in 25 of 33 patients (75.8％). There was more barium sulfate intake in the patients who had intestinal stasis than the patients who had no intestinal stasis. There was no relationship between intestinal stasis and the incidence of gastrointestinal complications. Our findings suggest that the risk of gastrointestinal complications after videofluoroscopic examination is low except in patients with a poor general condition.