邓宝梅,梁丽丝,赵嘉欣,等.不同稠度和容积吞咽任务对卒中后吞咽障碍患者吞咽生理成分表现及渗漏误吸的影响[J].中华物理医学与康复杂志,2021,43(12):1073-1077
扫码阅读全文
|
| 不同稠度和容积吞咽任务对卒中后吞咽障碍患者吞咽生理成分表现及渗漏误吸的影响 |
|
| |
| DOI：10.3760/cma.j.issn.0254-1424.2021.12.005 |
| 中文关键词: 脑卒中 吞咽障碍 吞咽生理成分 渗漏 误吸 |
| 英文关键词: Stroke Dysphagia Swallowing components Penetration Aspiration |
| 基金项目:国家重点研发项目（2018YFC2001603）；国家自然科学基金项目青年基金（81802236） |
|
| 摘要点击次数: 2254 |
| 全文下载次数: 2796 |
| 中文摘要: |
| 目的 探讨不同稠度和容积吞咽任务对卒中后吞咽障碍患者吞咽生理成分表现及渗漏误吸的影响。 方法 选取在我院康复科治疗的59例脑卒中后吞咽障碍患者作为研究对象，参照中国改良容积粘度测试程序，按2、1、0、3号（分别对应中稠度、低稠度、硫酸钡原液及高稠度）顺序分别对每种稠度食物进行3、5、10 ml的吞咽造影检查。使用标准化吞钡造影功能障碍评价量表（MBSImP）和Rosenbek渗漏/误吸量表进行量化分析。记录患者在执行不同稠度及容积吞咽任务时其各个吞咽生理成分评分和渗漏误吸分级。 结果 入选患者舌控制、咽期吞咽启动及喉关闭均在吞咽0号食物时表现较差，口腔残留在执行大容积吞咽任务时表现较差，咽蠕动在执行较小容积吞咽任务时表现较差。入选患者在执行低稠度、大容积吞咽任务时发生渗漏误吸的风险较高；其渗漏误吸分级与咽期总分间具有明显正相关性（r=0.365，P<0.01），并以喉关闭与渗漏误吸分级间的相关性尤为显著（r=0.772，P<0.01）。 结论 脑卒中吞咽障碍患者口咽期各吞咽生理成分的表现与进食食物稠度及容积密切相关，患者在执行较低稠度、较大容积吞咽任务时发生渗漏误吸的风险较高。 |
| 英文摘要: |
| Objective To explore the effect of swallowing different viscosities and volumes on the swallowing of dysphagic stroke survivors, and also penetration and aspiration. Methods A total of 59 stroke survivors with dysphagia were evaluated using videofluoroscopy while completing the Chinese version of the volume viscosity swallow test. They were required to swallow 3, 5 and 10ml of food of medium, low, zero and high viscosity. Modified barium swallowing impairment profiles (MBSImPs) and the Rosenbek penetration aspiration scale were used for quantitative analysis. Results Tongue control, initiation of the pharyngeal swallow and larynx closure showed the worst performance when swallowing zero-viscosity food. Oral residue performance was poor when swallowing large volumes and pharyngeal peristalsis was poor with small volumes. The risk of penetration and aspiration was greater with low-viscosity, large-volume swallowing tasks. There was a significant positive correlation between the penetration aspiration grade and total pharyngeal score. Larynx closure was especially strongly correlated with the penetration aspiration grade. Conclusions The characteristics of physiological swallowing are closely related to the viscosity and volume of the material being swallowed. The risk of penetration and aspiration is greater with large volumes of low-viscosity food. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
