食团体积与鼻咽癌吞咽障碍患者的舌骨位移相关性  

The relationship between bolus volume and hyoid displacement in dysphagia patients with nasopharyngeal carcinoma after radiation therapy

作　　者：陈丽珊[1] 周惠嫦[1] 张盘德 林楚克[1] 梁鹏[1] 关志勇[1] 袁家健 Chen Lishan;Zhou Huichang;Zhang Pande;Lin Chuke;Liang Peng;Guan Zhiyong;Yuan Jiajian(Department of Rehabilitation Medicine,The First People′s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院康复医学科,佛山528000

出　　处：《中华物理医学与康复杂志》2019年第12期894-899,共6页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：佛山市卫生和计生局医学科研课题(20180028)。

摘　　要：目的探讨一口量食团体积与鼻咽癌放疗后吞咽障碍患者舌骨位移的相关性。方法选取鼻咽癌放疗后吞咽障碍患者23例,在吞咽造影检查下,分别吞咽一口量为3、5、10和20 ml的国际吞咽障碍食物标准(IDDSI)分级为2级的流质食物,采集并测量舌骨垂直方向、舌骨水平方向的位移幅度和舌骨的运动时间,分析一口量食团体积与舌骨位移、舌骨运动时间的相关性。结果患者舌骨的垂直方向位移幅度平均值为(1.01±0.65)cm,提示吞咽10 ml食团的垂直位移幅度最大(P<0.05);舌骨的水平方向位移幅度平均值为(0.39±0.34)cm,提示吞咽3 ml食团的水平位移幅度最小(P<0.05);舌骨运动时间的平均值为(2.11±0.65)s,提示吞咽10和20 ml食团的舌骨运动时间较吞咽3和5 ml食团的时间短(P<0.05)。患者的舌骨运动时间与舌骨水平方向位移呈负相关性(P<0.05)。一口量食团体积与舌骨运动时间呈负相关性(P<0.05),与渗漏误吸分级(PAS)呈正相关性(P<0.05)。结论一口量食团体积对鼻咽癌放疗后吞咽障碍患者的舌骨位移幅度和舌骨运动时间均有一定程度的影响,对于PAS≤5级的患者,建议食团一口量以5~10 ml为宜。Objective To evaluate the relationship between bolus volume and hyoid displacement in dysphagia patients with nasopharyngeal carcinoma after radiation therapy.Methods Twenty-three nasopharyngeal carcinoma patients with dysphagia were recruited and their swallowing of 3,5,10 and 20ml of liquid food was studied fluoroscopically.The vertical and horizontal displacement of the hyoid as well as its time in motion were measured,and the relationship between the bolus volume,hyoid displacement and time in motion time was evaluated.Results The largest vertical displacement of the hyoid(1.01±0.65cm)was observed when swallowing a 10ml bolus.The hyoid showed the smallest average horizontal displacement(0.39±0.34cm),when swallowing a 3ml bolus.The average motion time of the hyoid was(2.11±0.65)seconds.It was shorter when swallowing a 10 or 20ml bolus than when dealing with a smaller one.Hyoid motion time was negatively correlated with the horizontal displacement of the hyoid bone,and the volume of a swallow was negatively correlated with the hyoid motion time but positively correlated with the penetration-aspiration scale score.Conclusion Bolus volume affects hyoid displacement and hyoid motion time in nasopharyngeal carcinoma patients with dysphagia after radiation therapy.For patients with a penetration-aspiration scale score of 5 or less,the optimum bolus volume is 5 to 10ml.

关 键 词：食团体积 舌骨位移 鼻咽癌 放疗 吞咽障碍 

分 类 号：R73[医药卫生—肿瘤]