超声评估健康人吞咽过程中食物黏滞度对颏舌骨肌运动的影响

The effects of bolus viscosity on geniohyoid muscle mevemeats in beslthy subjects as evaluated by ultrsonography

目的实时B型和M型（B／M型）超声引导下观察食物黏滞度对健康人群吞咽过程中颏舌骨肌运动的影响。方法应用实时B／M型超声测量30例健康志愿者（男15例，女15例）分别吞咽5ml果汁样、薄液样、蜂蜜样以及布丁样黏滞度食物过程中颏舌骨肌的运动范围和运动持续时间。每例受试者测量3次取平均值。结果随着食物黏滞度的增加，颏舌骨肌运动范围和运动持续时问均增加，差异有统计学意义（P〈0．01），吞咽果汁样、薄液样、蜂蜜样、布丁样食物时，颏舌骨肌运动范围分别为（6．993±1．776）mm、（7．463±1．947）mm、（8．446±2．293）mm、（8．905±2．057）mm，运动持续时间分别为（0．899±0．129）s、（1．019±0．149）s、（1．119±0．111）s、（1．211±0．141）s；各黏滞度间两两比较发现，颏舌骨肌运动范围在果汁样和薄液样、蜂蜜样和布丁样黏滞度食物之间差异无统计学意义（P〉0．05），其余黏滞度食物之间差异均有统计学意义（P〈0．05），而颏舌骨肌运动持续时间在各黏滞度食物间差异均有统计学意义（P〈0．01）；吞咽相同黏滞度食物时，男性颏舌骨肌运动范围和运动持续时间总是大于女性，且差异有统计学意义（P〈0．05）。结论实时B／M型超声可以清晰显像吞咽过程中颏舌骨肌的运动；食物黏滞度可以对颏舌骨肌运动产生影响；颏舌骨肌运动持续时间是评价食物黏滞度对颏舌骨肌运动影响的良好指标。

Objective To observe the movement patterns of the geniohyoid muscle in swallowing of healthy subjects by using the real-time B/M-mode ultrasound imaging. Metheds Thirty healthy subjects were recruited and the movement patterns of their geniohyoid muscles in swallowing of 5 ml juice-like, thin liquid, honey-like and budding-like bolus. The parameters included the range and the duration of geniohyoid muscle movement. Each subject was measured for 3 times to get the average. Results The range of geniohyoid muscle movement in swallowing of the above bolus was （6.993 ±1.776）mm, （7.463 ±1.947）mm, （8.446±2.293）mm and （8.905 ±2.057）mm, respectively, with significant differences among them except that between juice-like and thin liquid bolus swallowing, as well as between honey-like and budding-like bolus swallowing. The duration of geniohyoid muscle movement was （0.899±0.129）s, （1.019±0.149）s, （1.119±0.111）s and （1.211±0.141）s in juice-like, thin liquid, honey-like and budding-like bolus swallowing, with significant differetesamong them. When swallowing the same bolus, the range and duration of geniohyoid muscle movement of males were significantly longer than those of females. Conclusions B/M-mode imaging provides a useful technique for assessraent the movement of the geniohyoid muscle. The bolus viscosity has an impact on the movement of the geaiohyoid muscle. Compared with the range of movement,the duration of geniohyoid muscle movement is a better index for evaluating the effect of bolus viscosity on the geniohyoid muscle movement.