超声测量舌运动参数在脑卒中假性球麻痹患者康复治疗中的价值  

Value of ultrasound measurement of tongue motor parameters in rehabilitation treatment of pseudoglobular palsy after stroke

作　　者：曾庆宇 吕婉秋 张金生[3] 田力[2] ZENG Qingyu;LYU Wanqiu;ZHANG Jinsheng;TIAN Li(Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Ultrasound,Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Encephalopathy,Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学,河南郑州450003 [2]河南中医药大学第三附属医院超声科,河南郑州450003 [3]河南中医药大学第三附属医院脑病科,河南郑州450003

出　　处：《中国中西医结合影像学杂志》2024年第6期687-690,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:应用超声测量舌运动参数为脑卒中假性球麻痹患者的康复治疗和预后评估提供诊断依据。方法:选取40例脑卒中假性球麻痹患者,采用B/M型超声分别于治疗前和治疗2周后测量唾液吞咽过程中冠状面舌体的运动幅度、运动时间,计算其平均运动速度,比较治疗前后超声测量值的差异;根据入院7 d内是否新发肺部感染,将40例分为卒中相关性肺炎(SAP)组22例和非SAP组18例。比较治疗前后2组舌运动幅度、运动时间及运动速度超声参数的差异。以ICC评价观察者内及观察者间超声吞咽参数测量结果的一致性。结果:观察者内及观察者间测量舌运动幅度及舌运动时间的一致性均良好(ICC0.818~0.905,均P<0.05)。经2周康复治疗后,假性球麻痹患者舌运动幅度、运动速度较治疗前均增加,运动时间较治疗前减少(均P<0.01);2组组内治疗前及治疗后舌运动幅度、运动时间及运动速度差异均有统计学意义(均P<0.05);经2周康复治疗后,2组间舌运动幅度差值、运动时间差值及运动速度差值差异均有统计学意义(均P<0.05)。结论:超声可重复测量舌运动幅度、运动时间,并计算其运动速度;超声测量舌运动参数对脑卒中假性球麻痹患者的康复治疗和预后评估有较高的参考价值。Objective:To explore the value of ultrasound measurement of tongue motor parameters in the rehabilitation and prognosis evaluation of pseudoglobular palsy after stroke.Methods:A total of 40 patients with pseudobulbar palsy after stroke were selected,and all patients underwent B/M ultrasound examination.The movement amplitude and time of coronal tongue during saliva swallowing before and after 2 weeks of treatment were measured,and its average moving speed was calculated.The differences between the measured values before and after treatment were compared.According to whether they had new symptoms of pulmonary infection within 7 days after admission,all patients were divided into two groups,22 cases with stroke associated pneumonia(SAP)were SAP group and 18 cases were non-SAP group.The ultrasound parameters of tongue,such as the movement amplitude,time and speed,were compared between the two groups before and after treatment.The consistency of ultrasonic swallowing parameters of intra-and inter-observer was evaluated.Results:The intra-and inter-observer consistencies of tongue movement amplitude and time were good(ICC of 0.818~0.905,all P<0.05).After 2 weeks of rehabilitation treatment,the movement amplitude and speed of tongue increased,while the movement time decreased(all P<0.01).There were significant differences in tongue movement amplitude,time and speed between non-SAP group and SAP group before and after treatment(all P<0.05).After 2 weeks of rehabilitation treatment,the difference values of tongue movement amplitude,time and speed between non-SAP group and SAP group were statistically significant(all P<0.05).Conclusions:Ultrasound can measure the tongue movement amplitude and time repeatedly and calculate its speed.Ultrasonic measurements of tongue movement parameters have a good reference value for rehabilitation treatment and prognosis assessment of stroke patients with pseudobulbar palsy.

关 键 词：超声检查 吞咽障碍 康复治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]