麦艺颖，谢纯青，戴萌，姜丽，窦祖林.电视透视吞咽检查定量评价脑干梗死患者吞咽障碍特点的临床研究[J].中华物理医学与康复杂志,2018,40(2):87-90
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| 电视透视吞咽检查定量评价脑干梗死患者吞咽障碍特点的临床研究 |
| Dysphagia after brain stem infarction: A quantitative analysis of videofluoroscopic observations |
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| DOI： |
| 中文关键词: 脑干梗死 吞咽障碍 电视透视吞咽检查 |
| 英文关键词: Brain stem infarction Dysphagia Videofluoroscopy |
| 基金项目:国家自然科学基金资助项目（81672256），广东省省级科技计划项目（2013B090600048） |
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| 中文摘要: |
| 目的 采用电视透视吞咽检查（VFSS）数字化分析方法，定量分析脑干梗死后吞咽障碍患者吞咽障碍的特点,并分析各项参数与误吸严重程度的相关性。 方法 采用吞咽造影数字化分析方法采集脑干梗死后吞咽障碍患者12例（患者组）和健康受试者10例（健康组）的VFSS影像资料，每例受检者按要求1次性吞咽浓流质5ml，每例完成2次吞咽。分析的参数包括口腔运送时间（OTT），吞咽反应时间（SRT），舌骨运动时间（HMT），食道上括约肌开放时间（UOT），喉关闭时间（LCT）；同时采用8分制渗漏误吸量表（PAS）评估患者误吸严重程度，并分析各项参数与误吸严重程度的相关性。 结果 患者组的OTT［（3.091±1.803）s］、HMT［（1.498±0.550）s］、LCT［（0.651±0.186）s］与健康组比较，均显著延长，差异均有统计学意义（P<0.05），且SRT与误吸严重程度呈正相关（r=0.440，P=0.032）。 结论 脑干梗死患者的吞咽障碍表现涉及口腔期及咽期。OTT、HMT、LCT等参数可用于脑干梗死后吞咽障碍的评估，SRT可用于预测误吸的发生。 |
| 英文摘要: |
| Objective To evaluate the characteristics of dysphagia after brain stem infarction, and to determine the mechanism of aspiration. Methods The fluoroscopic videos of 12 dysphagia patients who had suffered brain stem infarction and 10 healthy counterparts were analyzed quantitatively using a digital analysis system. Each participant was requested to twice swallow 5ml of thick liquid. The observations included the oral transit time (OTT), the swallow response time (SRT), the hyoid movement time (HMT), the upper esophageal sphincter opening time (UOT) and the laryngeal closure time (LCT). An 8-point penetration-aspiration scale (PAS) was used to evaluate the severity of aspiration, and the results were correlated with the other 5 quantitative observations. Results The average OTT ［(3.091±1.803)s］, HMT ［(1.498±0.550)s］ and LCT ［(0.651±0.186)s］ of the brain stem infarction patients were all significantly longer than those of the healthy controls. However, no significant differences were found between the patients and the healthy volunteers in terms of SRT or UOT. Aspiration severity was significantly correlated with SRT but not with LCT. Conclusion Dysphagia after brain stem infarction involves both the oral and pharyngeal phases. OTT, HMT and LCT can be used to quantify dysphagia after brain stem infarction, while SRT is a predictor of aspiration. |
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