戴萌，万桂芳，王玉珏，卫小梅，谢纯青，武惠香，窦祖林.吞咽造影量化分析的信度研究[J].中华物理医学与康复杂志,2015,37(12):908-912
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| 吞咽造影量化分析的信度研究 |
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| DOI： |
| 中文关键词: 吞咽造影 量化分析 信度 时间学参数 运动学参数 |
| 英文关键词: Videofluoroscopy Qualitative analysis Reliability Temporal parameters Kinematic parameters |
| 基金项目:广东省教育部产学研结合项目（2013B090600048） |
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| 中文摘要: |
| 目的采用自主开发的吞咽造影数字化采集与分析系统进行吞咽造影时间学参数和运动学参数的量化分析，确定该分析方法的信度。 方法选取吞咽功能障碍患者18例，接受标准吞咽造影检查，分别选择质地为3ml、5ml由600kg/m3硫酸钡混悬液调制的稀流质、浓流质、糊状食团，每位受试者共进行6次吞咽。由两名分析者分别对所采集的吞咽造影视频进行间隔时间为4周的2次分析，分析参数包括口腔运送时间、软腭上抬时间、舌骨位移时间、喉关闭时间、环咽肌开放时间、舌骨向前位移、舌骨向上位移、环咽肌开放幅度及咽腔收缩率。 结果不同参数之间信度存在差异，除两名分析者测得的舌骨向前位移（HAM）及向上位移（HSM）的内测信度为0.41～0.60，信度欠佳，以及间测信度为0.61～0.80，信度中等外，其余参数信度均较好。 结论自主开发的吞咽造影数字化采集与分析系统信度比较理想，该软件可用于临床吞咽造影量化分析。 |
| 英文摘要: |
| Objective To analyze temporal and kinematic parameters of video fluoroscopic images of swallowing using a digital acquisition and analysis system and to verify the reliability of this method. MethodsEighteen patients with dysphagia were requested to completed six swallows (3 ml and 5 ml of thin liquid, thick liquid, and paste mixed with 600 kg/m3 barium sulfate suspension) in the natural sitting position. Video fluoroscopy was used to measure the oral transit times, soft palate elevation times, hyoid movement times, laryngeal closure times, cricopharyngeal muscle opening times, hyoid anterior movement (HAM), hyoid superior movement (HSM), cricopharyngeal muscle opening diameter and pharyngeal constriction rate. Each was extracted from the videos four times by two raters working separately with an interval of 4 weeks between the sets of evaluations. Results Reliability varied among the different observations. HAM and HSM showed inter-rater reliability between 0.41 and 0.60 and intra-rater reliability between 0.61 and 0.80. The other observations all demonstrated acceptable reliability. Conclusion The self-designed digital acquisition and analysis system tested showed acceptable reliability and could be applied to analyze swallowing function clinically. |
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