不同增稠剂对口咽期吞咽障碍患者渗漏误吸的影响  

Effects of different kinds of thickener on penetration and aspiration in patients with oropharyngeal dys phagia

作　　者：谢纯青[1] 张耀文[1] 张科 杨诚 李瑜琳 赵妃 窦祖林[1] XIE Chunqing;ZHANG Yaowen;ZHANG Ke(The Third Affiliated Hospital,Sun Yat-sen University,510630)

机构地区：[1]中山大学附属第三医院康复医学科,广州510630 [2]湖北工业大学生物工程与食品学院

出　　处：《中国康复医学杂志》2020年第3期283-287,共5页Chinese Journal of Rehabilitation Medicine

基　　金：广东省科技计划项目(2016A010105005);广州市科技计划项目(201604020153)。

摘　　要：目的:探讨淀粉类增稠剂、黄原胶类增稠剂及凝胶类增稠剂对口咽期吞咽障碍患者渗漏误吸的影响。方法:选取20例口咽期吞咽障碍患者进行吞咽造影检查(videofluoroscopic swallowing study,VFSS),患者随机顺序进食分别由淀粉类增稠剂、黄原胶类增稠剂及凝胶类增稠剂调制的高度稠/细泥型造影剂,观察患者的吞咽功能及不同增稠剂对其渗漏误吸情况的影响,并采用Rosenbek渗漏-误吸分级记录。结果:黄原胶类组与淀粉类组的渗漏误吸分级比较,及凝胶类组与淀粉类组的渗漏误吸分级比较,差异均具有显著性意义。结论:黄原胶类增稠剂及凝胶类增稠剂改善口咽期吞咽障碍患者渗漏误吸情况的效果优于淀粉类增稠剂,临床应用时应根据患者的误吸风险及吞咽能力更个体化地选择合适的增稠剂。Objective:To investigate the effects of starch thickener,xanthan gum thickener and gel thickener on penetration and aspiration in patients with oropharyngeal dysphagia.Method:Twenty patients with oropharyngeal swallowing disorder were performed videofluoroscopic swallowing study(VFSS).Patients were given extremely thick/pureed contrast agents made of starch thickener,xanthan gum thickener or gel thickener in a random order to observe the swallowing function and the influence of different thickeners by assessing Rosenbek penetration aspiration scale(PAS).Result:The difference between xanthan gum group and starch group,and the difference between gel group and starch group were statistically significant.Conclusion:Xanthan gum thickener and gel thickener can both decrease the incidence rate of penetration and aspiration of patients with oropharyngeal dysphagia,which is better than starch thickener.The appropriate thickener should be selected according to the patient's risk of aspiration and swallowing ability.

关 键 词：吞咽障碍 渗漏 误吸 增稠剂 

分 类 号：R493[医药卫生—康复医学]