脑卒中患者舌压力与吞咽困难的相关性研究

Relationship between tongue pressure and oral dysphagia in stroke patients

摘要:

目的分析在脑卒中吞咽困难患者中，舌压在口腔期吞咽运动不同方面的差异。方法回顾性分析60 例脑卒中并吞咽困难患者其舌压和吞咽困难的关系。电视透视检查（VFSS）对吞咽功能行临床评估，爱荷华口腔行为仪检测舌压，记录嘴唇闭合压力（LP）、前硬颚舌压力（AP）、后硬颚舌压力（PP）、患侧颊舌压力（BW）及健侧颊舌压力（BH），每组数据测定3 次取平均值。结果AP 和PP 在嘴唇闭合充分组、食团形成充分组、口期时长正常组高于闭合不充分组、食团形成不充分组和口期延长组（p <0.05），LP、BW 及BH 与嘴唇闭合程度、食团形成和口期时长无关（p >0.05）；LP、AP、PP、BW 及BH在咀嚼正常组和舌腭接触紧密组均高于咀嚼不充分组和舌腭接触不紧密组（p <0.05）；AP、PP、BW、BH及LP 降低与口腔期吞咽后食物残留量增加相关（p <0.05）。结论舌压与脑卒中吞咽困难患者的口腔期吞咽功能尤其是食团形成、咀嚼、口腔残留量、舌腭接触紧密性及口期时长密切相关。

关键词:吞咽困难;卒中;舌压;电视透视检查

Abstract:

To analyze the relationship between tongue pressure and different aspects of the oral swallowing function in stroke and dysphagia patients. Methods We retrospectively analyzed 60 stroke and dysphagia patients. VFSS (video fluoroscopic swallowing study) was used to evaluate the swallowing function in clinic. Measurements of tongue pressure were obtained with the iowa oral performance instrument. Lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), posterior hard palate-to-tongue pressure (PP),buccal-to-tongue pressure, on the weak side (BW) and buccal-to-tongue pressure, on the healthy side (BH) were collected. Each date was measured three times and average date was used. Results AP and PP were higher in the intact LC group, adequate BF group and normal OTT groupthan those in the inadequate lip closure group, inadequate BF group and lengthened OTT (p < 0.05), LP, BW and BH were not related to LC,BF and OTT (p > 0.05). LP, AP, PP, BW and BH were significantly higher in the groups with intact mastication and tight TP (p < 0.05). Furthermore, PBL would significantly increase by lower LP, PP, AP, BW and BH. Conclusions The tongue pressures are closely related to the oral-phase swallowing function in stroke and dysphagia patients, especially BF, mastication, PBL, TP and OTT.

Key words:dysphagia; stroke; tongue pressure; video fluoroscopic swallowing study