戴萌,张耀文,安德连,等.吞咽造影检查在脑卒中患者口服胶囊吞咽功能评估中的应用研究[J].中华物理医学与康复杂志,2019,41(9):647-650
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| 吞咽造影检查在脑卒中患者口服胶囊吞咽功能评估中的应用研究 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.09.002 |
| 中文关键词: 脑卒中 吞咽造影 口服药 吞咽功能 吞咽障碍 |
| 英文关键词: Stroke Videofluoroscopy Oral medication Swallowing Dysphagia |
| 基金项目:广东省省级科技计划项目（2016A010105005） |
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| 中文摘要: |
| 目的 运用吞咽造影检查评估脑卒中后患者的口服胶囊吞咽功能，探讨其应用价值。 方法 选取脑卒中后功能性经口摄食量表（FOIS）分级4～7级且饮水无误吸的患者27例（脑卒中组）及健康人16例（对照组）。脑卒中组及对照组均在吞咽造影检查过程中用水送服硫酸钡混悬剂填充的胶囊。由专业人员对造影视频进行分析，获取吞服胶囊的成功率，记录胶囊吞咽的口腔期运送时间（OTT）、咽期吞咽的启动时间（STT）、胶囊在咽期的运送时间(PTT)、环咽肌开放时间(UOT)、胶囊与水通过环咽肌的时间间隔(DT)，记录舌骨的向上位移（HSM）、向前位移（HAM）及环咽肌开放幅度(UOD)等运动学参数。 结果 脑卒中组患者胶囊吞咽的成功率为78.3%，较对照组低（P<0.05），吞咽障碍主要表现为口腔或咽腔运送障碍，在口咽期滞留。脑卒中组的STT［ms，66.0（-66.5,217.0）］、DT［ms，67.0（283.5,184.0）］较对照组有显著差异（P<0.05）。 结论 脑卒中后患者的经口进食能力虽然有一定程度的恢复，但仍存在口服药物吞咽困难。吞咽造影可作为一种评估手段，用于临床评估患者的口服药物能力。 |
| 英文摘要: |
| Objective To explore the value of videofluoroscopy in assessing the capsule swallowing ability of stroke survivors. Methods Twenty-seven stroke survivors with functional oral intake scale ratings of 4-7 with no aspiration were selected as a patient group, while 16 healthy subjects were chosen as a control group. All swallowed capsules filled with barium sulfate with water while being monitored videofluoroscopically. The success rate of capsule swallowing was recorded along with oral transit time, stage transition time (STT), pharyngeal transition time, the upper esophageal sphincter (UES) opening time, delay time (DT), superior hyoid bone movement, anterior hyoid bone movement and UES opening diameter for each swallowing. Results The swallowing success ratio was 78.3% in the patient group, significantly lower than in the control group. Swallowing failures manifested as hindered transport and retention of the capsule in the oral or pharyngeal cavity. Significant differences were found in STT and DT between the two groups. Conclusion Even if eating and swallowing ability recover somewhat after a stroke, survivors still have difficulty swallowing oral medication. Clinical assessment for ability to take oral medication is crucial and videofluoroscopy can be one useful tool. |
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