脑卒中后咽期吞咽障碍患者舌骨和颏舌骨肌的超声评价研究  

Ultrasound evaluation of hyoid and geniohyoid muscle in patients with pharyngeal dysphagia after stroke

作　　者：张新颜[1] 刘莉[1] 张戈[2] 章洁[1] 朱慧敏[1] 吴桐[3] 田丽[1] Zhang Xinyan;Liu Li;Zhang Ge(Department of Rehabilitation Medicine, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学附属脑科医院康复医学科,南京210029 [2]南京医科大学附属脑科医院老年医学科,南京210029 [3]南京医科大学附属脑科医院物理诊断科超声室,南京210029

出　　处：《中国康复》2021年第11期653-656,共4页Chinese Journal of Rehabilitation

摘　　要：目的:通过B/M型超声测量脑卒中后吞咽障碍患者的舌骨和颏舌骨肌运动参数,探讨其在咽期吞咽困难程度评估中的价值。方法:选取脑卒中患者40例为研究对象,均经吞咽造影检查证实存在咽期吞咽障碍。选用视频吞咽障碍分级量表(VDS)中的7项咽期指标进行评定,满分为60分。根据评分将患者分为<30分(轻度组)和≥30分(重度组)2组。使用超声测量2组空吞咽时的舌骨位移、颏舌骨肌运动距离和运动时间。并记录2组的管饲喂食情况。结果:轻度组舌骨位移、颏舌骨肌运动距离大于重度组(P<0.05)。2组颏舌骨肌运动时间比较无明显差异。2组管饲情况比较差异有统计学意义(P<0.05)。结论:超声可以对舌骨和颏舌骨肌的位移等运动规律进行定量检测,有助于对脑卒中后咽期吞咽障碍患者吞咽困难程度的分析,为临床康复治疗提供量化指标。Objective:To explore the value in the evaluation of dysphagia degree,B/M ultrasonography was used to measure the motion parameters of hyoid and geniohyoid muscles in stroke patients with pharynx dysphagia.Methods:Forty stroke patients were selected as the study subjects,all of whom were confirmed to have dysphagia in pharynx by swallowing angiography.Seven pharyngeal indicators in the Video Dysphagia Dysfunction Scale(VDS)were selected for evaluation,with the full score of 60.According to the results,the patients were divided into two groups:<30 score(mild group)and≥30 score(severe group).Ultrasound was used to measure hyoid displacement,geniohyoid muscle movement distance and movement time during empty swallowing.The tube feeding conditions of the two groups were recorded.Results:Hyoid displacement and geniohyoid muscle movement distance in mild group were higher than those in severe group(P<0.05).There was no significant difference in the movement time of geniohyoid muscle between the two groups.Only few patients in the mild group needed to be fed,and all patients in the severe group needed to be fed,showing statistical difference between the two groups(P<0.05).Conclusion:Ultrasonography can quantitatively detect the kinematology of the hyoid displacement and geniohyoid muscle movement,which is helpful to analyze the degree of dysphagia in patients with pharyngeal dysphagia after stroke,and provide quantitative indicators for clinical rehabilitation treatment.

关 键 词：超声 吞咽障碍 舌骨位移 颏舌骨肌 脑卒中 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]