脑卒中患者吞咽功能障碍的超声检查与评估

Ultrasonographic examination and evaluation of dysphagia in stroke patients

目的通过B/M型超声研究颏舌骨肌的运动变化规律,评估其在脑卒中患者吞咽功能障碍康复治疗中的应用价值。方法选取2017年2月至2018年12月在同济大学附属杨浦医院就诊的经综合康复治疗3个月后吞咽功能恢复正常的30例患者(病例组)为研究对象,应用B/M型超声分别于康复治疗前、治疗3周、痊愈后观察患者吞咽5 ml矿物质水过程中颏舌骨肌的运动时间、运动距离及平均运动速度。招募20例无吞咽功能障碍的健康老年人作为对照组,超声观察颏舌骨肌的运动。结果健康老年人颏舌骨肌的运动距离、运动时间、平均运动速度分别为(7.798±0.996)mm、(0.897±0.113)s、(8.696±0.915)mm/s。脑卒中伴吞咽功能障碍患者治疗前:颏舌骨肌的运动距离、运动时间、平均运动速度分别为(6.178±0.847)mm、(1.672±0.195)s、(3.719±0.885)mm/s。脑卒中伴吞咽功能障碍患者治疗3周:颏舌骨肌的运动距离、运动时间、平均运动速度分别为(6.833±0.805)mm、(1.331±0.151)s、(5.735±0.684)mm/s。脑卒中伴吞咽功能障碍患者痊愈后:颏舌骨肌的运动距离、运动时间、平均运动速度分别为(7.693±0.422)mm、(0.848±0.294)s、(8.591±0.984)mm/s。结论B/M型超声能准确定量评估脑卒中伴吞咽功能障碍患者颏舌骨肌功能改善情况,为康复治疗提供依据。

Objective To investigate the motor changes of the geniohyoid muscle in stroke patients with dysphagia and evaluate the value of ultrasound in the rehabilitation treatment of swallowing function.Methods Thirty patients(case group)whose swallowing function returned to normal within 3 months after comprehensive rehabilitation treatment were selected as the subjects.From the day of admission,the patients were treated for 3 weeks.After treatment,the movement range,movement time,and average movement speed of the geniohyoid muscle during swallowing 5 ml of mineral water were observed by B/M ultrasound.Twenty healthy elderly people without swallowing dysfunction were recruited as a control group.The movement of the geniohyoid muscle was observed by ultrasound.Results The movement range,movement time,and average speed of the geniohyoid muscle in the healthy elderly people were(7.798±0.996)mm,(0.897±0.113)s,and(8.696±0.915)mm/s,respectively.Before treatment,the range of movement,movement time,and average speed of the geniohyoid muscle in stroke patients with dysphagia were(6.178±0.847)mm,(1.672±0.195)s,and(3.719±0.885)mm/s,respectively.After treatment for 3 weeks,the range of movement,movement time,and average speed of the genioglossus muscle were(6.833±0.805)mm,1.331s,and(5.735±0.684)mm/s,respectively.After recovery of stroke patients with dysphagia,the range of movement,movement time,and average speed of the genioglossus muscle were(7.693±0.422)mm,(0.848±0.294)s,and(8.591±0.984)mm/s,respectively.Conclusion B/M ultrasound can accurately and quantitatively evaluate the improvement of genioglossus muscle function in stroke patientswith dysphagia, and provide a basis for rehabilitation treatment.