脑卒中后吞咽障碍病人超声评估标准的研究

    Study on the ultrasonographic evaluation criteria for post-stroke dysphagia patients

    • 摘要:
      目的为超声技术在卒中后吞咽障碍诊断、疗效评估标准的制定提供参考。
      方法纳入健康成人500名,利用超声观察静息状态下舌骨与甲状软骨间的距离、吞咽过程中舌骨和甲状软骨间的最短距离,计算出在整个吞咽过程中,舌骨和甲状软骨两者间距离的缩短率。同时招募卒中后吞咽障碍的病人56例,行综合康复治疗,治疗前后同样进行上述超声检查。对比分析病人治疗前后舌骨和甲状软骨间距离的缩短率以及与健康成人的差异。
      结果卒中后吞咽障碍病人舌骨和甲状软骨间的最短距离以及舌骨和甲状软骨两者间距离的缩短率低于健康成人(P < 0.01)。治疗后,病人舌骨和甲状软骨间距离缩短率(47.0±8.7)%,较治疗前(27.5±6.2)%提高(t=13.66,P < 0.01)。
      结论超声能够定量测量舌骨和甲状软骨间距离的缩短率,脑卒中后吞咽障碍病人舌骨和甲状软骨间距离的缩短率显著降低。

       

      Abstract:
      ObjectiveTo provide a reference for the development of diagnostic and efficacy assessment criteria for ultrasound technology in post-stroke dysphagia.
      MethodsThe distance between the hyoid bone and thyroid cartilage at rest and the shortest distance between the hyoid bone and thyroid cartilage during deglutition were observed using ultrasonography in 500 healthy adults.The shortening rate of the distance between the hyoid bone and thyroid cartilage during deglutition was calculated.Fifty-six patients with post-stroke dysphagia were recruited for comprehensive rehabilitation treatment, and the same ultrasound examinations were also performed before and after treatment as described above.The shortening rate of hyoid bone and thyroid cartilage before and after treatment was compared with those of healthy adults.
      ResultsThe shortest distance between the hyoid bone and thyroid cartilage and the shortening rate of the distance between the hyoid bone and thyroid cartilage were lower in patients with post-stroke dysphagia than those in healthy adults (P < 0.01).After treatment, the patients showed a (47.0±8.7)% increase in the distance between the hyoid bone and thyroid cartilage compared with (27.5±6.2)% before treatment (t=13.66, P < 0.01).
      ConclusionsUltrasound is able to quantify the shortening rate of hyoid bone and thyroid cartilage, which is significantly reduced in patients with post-stroke dysphagia.

       

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