中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
Chinese Journal of Physical Medicine and Rehabilitation
2015年
8期
577-580
,共4页
兰月%徐光青%林拓%江力生%窦祖林
蘭月%徐光青%林拓%江力生%竇祖林
란월%서광청%림탁%강력생%두조림
脑卒中%吞咽障碍%吞咽造影%球囊扩张术
腦卒中%吞嚥障礙%吞嚥造影%毬囊擴張術
뇌졸중%탄인장애%탄인조영%구낭확장술
Stroke%Deglutition disorders%Videofluoroscopy%Balloon dilatation
目的 使用吞咽造影数字化分析方法观察改良球囊扩张术治疗对脑干卒中后吞咽障碍患者咽部收缩功能的影响,定量评价脑干卒中后吞咽功能变化.方法 选取30例脑干卒中后经吞咽造影诊断为咽期吞咽障碍的患者,按患者治疗方法的不同,将接受球囊扩张术治疗的15例患者设为球囊扩张组,接受常规吞咽治疗的15例患者设为常规治疗组.球囊扩张组给予球囊扩张术治疗和常规吞咽康复治疗,各1次/日,每次30 min;常规治疗组仅给予常规吞咽康复训练,2次/日,每次30 min;2组治疗均为5次/周,共3周.分别于治疗前和治疗后,进行吞咽造影评估和数字化测量分析,测量指标包括咽收缩率和咽收缩持续时间.结果 治疗后球囊扩张组在吞咽稀流质、浓流质及糊状食物时,患者的咽收缩率分别为(0.20±0.03)、(0.14 ±0.05)和(0.15±0.04),治疗前后差异均有统计学意义(P＜0.05);治疗后球囊扩张组患者吞咽稀流质、浓流质及糊状食物时咽收缩持续时间分别为(990.34±96.14)、(1010.47±133.64)和(1180.10±121.27)ms,治疗前、后差异有统计学意义(P＜0.05).常规治疗组患者治疗后吞咽稀流质、浓流质及糊状食物时的咽收缩率及咽收缩持续时间治疗前后差异亦有统计学意义(P＜0.05).结论 吞咽造影数字化分析能够有效地量化吞咽功能,咽收缩率及咽收缩持续时间可用于分析咽部功能治疗前后的变化.
目的 使用吞嚥造影數字化分析方法觀察改良毬囊擴張術治療對腦榦卒中後吞嚥障礙患者嚥部收縮功能的影響,定量評價腦榦卒中後吞嚥功能變化.方法 選取30例腦榦卒中後經吞嚥造影診斷為嚥期吞嚥障礙的患者,按患者治療方法的不同,將接受毬囊擴張術治療的15例患者設為毬囊擴張組,接受常規吞嚥治療的15例患者設為常規治療組.毬囊擴張組給予毬囊擴張術治療和常規吞嚥康複治療,各1次/日,每次30 min;常規治療組僅給予常規吞嚥康複訓練,2次/日,每次30 min;2組治療均為5次/週,共3週.分彆于治療前和治療後,進行吞嚥造影評估和數字化測量分析,測量指標包括嚥收縮率和嚥收縮持續時間.結果 治療後毬囊擴張組在吞嚥稀流質、濃流質及糊狀食物時,患者的嚥收縮率分彆為(0.20±0.03)、(0.14 ±0.05)和(0.15±0.04),治療前後差異均有統計學意義(P＜0.05);治療後毬囊擴張組患者吞嚥稀流質、濃流質及糊狀食物時嚥收縮持續時間分彆為(990.34±96.14)、(1010.47±133.64)和(1180.10±121.27)ms,治療前、後差異有統計學意義(P＜0.05).常規治療組患者治療後吞嚥稀流質、濃流質及糊狀食物時的嚥收縮率及嚥收縮持續時間治療前後差異亦有統計學意義(P＜0.05).結論 吞嚥造影數字化分析能夠有效地量化吞嚥功能,嚥收縮率及嚥收縮持續時間可用于分析嚥部功能治療前後的變化.
목적 사용탄인조영수자화분석방법관찰개량구낭확장술치료대뇌간졸중후탄인장애환자인부수축공능적영향,정량평개뇌간졸중후탄인공능변화.방법 선취30례뇌간졸중후경탄인조영진단위인기탄인장애적환자,안환자치료방법적불동,장접수구낭확장술치료적15례환자설위구낭확장조,접수상규탄인치료적15례환자설위상규치료조.구낭확장조급여구낭확장술치료화상규탄인강복치료,각1차/일,매차30 min;상규치료조부급여상규탄인강복훈련,2차/일,매차30 min;2조치료균위5차/주,공3주.분별우치료전화치료후,진행탄인조영평고화수자화측량분석,측량지표포괄인수축솔화인수축지속시간.결과 치료후구낭확장조재탄인희류질、농류질급호상식물시,환자적인수축솔분별위(0.20±0.03)、(0.14 ±0.05)화(0.15±0.04),치료전후차이균유통계학의의(P＜0.05);치료후구낭확장조환자탄인희류질、농류질급호상식물시인수축지속시간분별위(990.34±96.14)、(1010.47±133.64)화(1180.10±121.27)ms,치료전、후차이유통계학의의(P＜0.05).상규치료조환자치료후탄인희류질、농류질급호상식물시적인수축솔급인수축지속시간치료전후차이역유통계학의의(P＜0.05).결론 탄인조영수자화분석능구유효지양화탄인공능,인수축솔급인수축지속시간가용우분석인부공능치료전후적변화.
Objective To evaluate the effect of the modified balloon dilatation intervention on the pharyngeal constriction function of the brainstem stroke survivors with dysphagia using videofluoroscopy-based digital analysis.Methods Thirty brainstem stroke survivors with pharyngeal dysphagia were recruited and randomly divided into a treatment group and a control group,with 15 in each.The treatment group was treated with the modified balloon dilatation in addition to the routine treatment of 30min,respectively,once a daily,3 days a week,whiled a control group was treated with routine treatment of 30min twice a day,3 days a week.Before and after the treatment,the rate and duration of pharyngeal constriction were measured in both groups.Results After the treatment,the rate of pharyngeal constriction in the treatment group was (0.20 ± 0.030),(0.14 ± 0.05) and (0.15 ± 0.04) when swallowing thin liquid,thick liquid and pasty food,significantly better than before the treatment.The duration of the pharyngeal constriction was (990.34 ±96.14),(1010.47 ± 133.64) and (1180.10 ± 121.27) ms,respectively,also significantly better than before the treatment.In the control group,significant differences were also observed in the rate and duration of pharyngeal constriction before and after the treatment.Conclusions Digital analysis based on videofluoroscopy can be used to quantify swallowing function effectively,and the rate and duration of pharyngeal constriction can be used to evaluate the pharyngeal function before and after treatment.
