表面肌电图在环咽肌失弛缓患者吞咽障碍评定中的应用

Application of Surface Electromyography in Assessment of Dysphagia after Cricopharyngeal Achalasia

目的观察舌骨下肌群和颏下肌群表面肌电图(sEMG)在缺血性脑卒中后环咽肌失弛缓患者吞咽评定中的应用价值。方法2015年1月至2019年12月,本院缺血性脑卒中后咽期吞咽障碍患者48例,根据透视荧光吞咽检查(VFSS)结果,存在环咽肌功能异常者为观察组,无环咽肌功能异常者为对照组,各24例,同期选取健康志愿者24例为健康组。行sEMG检测,记录三组在静息,空吞咽,吞咽水、浓流质、糊状食物等不同模式下,舌骨下和颏下肌群的均方根值(RMS),观察RMS与VFSS的相关性。结果各组各肌群RMS均随吞咽难度提高而显著升高(F>77.652,P<0.001)。相同吞咽模式下,观察组各肌群RMS最高,其次为对照组和健康组(F>42.505,P<0.001)。各肌群RMS与VFSS评分呈正相关(r>0.548,P<0.05)。结论检测缺血性脑卒中后环咽肌失弛缓患者咽期颏下及舌骨下肌群sEMG,可初步揭示吞咽肌收缩力,为临床筛查和评估吞咽功能提供帮助。

Objective To apply surface electromyography(sEMG)in assessment of swallow function for patients with cricopharyngeal achalasia.Methods From January,2015 to December,2019,48 patients with dysphagia after ischemic stroke accepted videofluoroscopic swallowing study(VFSS);those with cricopharyngeal achalasia were as observation group(n=24),and those without cricopharyngeal achalasia were as control group(n=24).Other 24 healthy subjects were as healthy group.They accepted sEMG at infrahyoid muscles and submental muscles as they were resting,and swallowing nothing(saliva),water,thick fluid and semiliquid food.The root mean square(RMS)of sEMG was recorded.The correlation of RMS and VFSS was anlyzed.Results The RMS of both muscle groups increased with the difficuty of swallowing in all the groups(F>77.652,P<0.001).For every condition,the RMS of both muscle groups was the most in the observation group,and then for the control group and the healthy group(F>42.505,P<0.001).The RMS of both muscle groups positively correlated with VFSS score(r>0.548,P<0.05).Conclusion sEMG can be used to quantitatively assess the contraction of submental muscles and infrahyoid muscles in cricopharyngeal achalasia patients after ischemic stroke,which may help to evaluate swallowing function.