基于B/M型超声数字化评估脑卒中后吞咽障碍患者咽期吞咽动力学特征  

A clinical evaluation of swallowing dynamic characteristics in the pharyngeal phase of patients with dysphagia after stroke based on digital B/M ultrasound

作　　者：樊留博 韩文胜 沈佳雯 张露丁 罗咪咪 FAN Liubo;HAN Wensheng;SHEN Jiawen;ZHANG Luding;LUO Mimi(Department of Rehabilitation of Medical,Taizhou Hospital Affiliated to Wenzhou Medical University,Taizhou 317000,China;Department of Ultrasound,Taizhou Hospital Affiliated to Wenzhou Medical University,Taizhou 317000,China)

机构地区：[1]温州医科大学附属台州医院康复医学科,浙江台州317000 [2]温州医科大学附属台州医院超声科,浙江台州317000

出　　处：《温州医科大学学报》2023年第2期142-145,151,共5页Journal of Wenzhou Medical University

基　　金：浙江省自然科学基金项目(LSY19H170001);浙江省医药卫生科技计划项目(2022KY434)。

摘　　要：目的:应用实时B/M型超声观察脑卒中后咽期吞咽障碍患者颏舌骨肌活动参数及舌骨活动参数,探讨其在脑卒中后咽期吞咽困难程度评估价值及临床应用。方法:选取2021年1月至2021年12月在温州医科大学附属台州医院住院的脑卒中后吞咽障碍患者30例为观察组,同期另选取30例健康体检者为对照组。观察组均经吞咽造影检查(VFSS)确诊存在咽期吞咽障碍。两组受检者均由同一名超声科医师进行咽部超声检查,在所有受试者采用吞咽5 mL稀流质的情况下测量或计算舌骨至下颌骨间的最大距离、最小距离、所需时间,计算舌骨活动度、距离缩短率、颏舌骨肌活动度、活动时间、活动速度,比较两组各超声测量值间的差异。结果:观察组患者颏舌骨肌活动度及活动速度较对照组下降,活动时间较对照组延长(P<0.05);脑卒中后吞咽障碍患者下颌骨至舌骨活动度、活动速度及距离缩短率均较对照组下降,活动时间较对照组延长(P<0.05)。结论:B/M型超声可以对舌骨和颏舌骨肌的动力学参数进行定量检测,有助于对脑卒中后咽期吞咽障碍患者吞咽困难程度进行准确分析,为临床康复评估与治疗提供量化指标。Objective:To observe the geniohyoid muscle activity parameters and hyoid activity parameters in patients with dysphagia after stroke by real-time B/M ultrasound,and to explore its clinical value and application in the evaluation of dysphagia after stroke.Methods:Totally 30 patients with dysphagia after stroke in Taizhou Hospital of Zhejiang Province from January 2021 to December 2021 were selected as the observation group,and another 30 healthy subjects as the control group.Pharyngeal dysphagia was detected by pharyngography(VFSS)in all patients in the observation group.Pharynx ultrasonography was performed by the same ultrasound doctor in both groups.When all subjects swallowed 5 mL dilute fluid,the maximum distance,minimum distance and required time between hyoid and mandible were measured or calculated,hyoid mobility,distance shortening rate,geniohyoid muscle activity,activity time and activity speed were calculated,and the differences between the two groups were compared.Results:The observation group had lower activity range and speed of geniohyoid muscle,and longer activity time than the control group,with statistical difference(P<0.05).The range of motion,velocity and shortening rate of distance from mandible to hyoid in patients with dysphagia after stroke were lower than those in the control group,and the activity time was longer than that in the control group(P<0.05).Conclusion:B/M mode ultrasound can quantitatively detect the dynamic parameters of hyoid and geniohyoid muscles,which is helpful to accurately analyze the degree of dysphagia in patients with dysphagia after stroke and provide quantitative indexes for clinical rehabilitation evaluation and treatment.

关 键 词：超声 脑卒中 吞咽障碍 颏舌骨肌 舌骨 

分 类 号：R49[医药卫生—康复医学] R493[医药卫生—临床医学]