超声定量评估脑卒中后吞咽障碍患者颏舌骨肌

Quantitative ultrasound assessment of geniohyoid muscle in patients with post-stroke dysphagia

目的观察超声定量评估脑卒中后吞咽障碍患者康复治疗前后颏舌骨肌运动改变的价值。方法纳入40例接受康复治疗并于2个月内恢复正常吞咽功能的脑卒中后吞咽障碍患者。采用B/M型超声分别于治疗前、治疗2周及治愈后测量吞咽5 ml水过程中颏舌骨肌运动幅度及运动时间,计算其运动速度,比较不同时间点超声参数的差异;以组内相关系数(ICC)评价观察者内及观察者间超声参数测量结果的一致性。结果观察者内及观察者间测量颏舌骨肌运动幅度及运动时间的一致性均良好(ICC:0.854~0.932,P均<0.05)。治疗前、治疗后2周及治愈后患者颏舌骨肌运动幅度及运动速度逐渐增加,而运动时间逐渐减少(P均<0.01)。治疗2周时与治愈后颏舌骨肌运动幅度差异无统计学意义(P=0.66),其余各时间点各颏舌骨肌超声参数两两比较差异均有统计学意义(P均<0.01)。结论超声可定量评估颏舌骨肌运动参数,为康复治疗脑卒中后吞咽障碍患者提供参考。

Objective To observe the value of ultrasound for quantitatively assessment of the motor changes of geniohyoid muscle in patients with post-stroke dysphagia before and after rehabilitation.Methods Forty patients with post-stroke dysphagia who underwent rehabilitation and returned to normal swallowing function within 2 months were enrolled.B/M ultrasound was used to measure the amplitude and movement time of the geniohyoid muscle during swallowing 5 ml water before treatment,2 weeks after treatment and after cure,respectively.The movement velocity was calculated,and the ultrasonic parameters were compared among different time points.Then intra-class correlation coefficient(ICC)was calculated to evaluate the intra-and inter-observer consistency of measurements of ultrasound parameters.Results Both the intra-and inter-observer agreement for measuring geniohyoid muscle movement amplitude and movement time were good(ICC:0.854-0.932,all P<0.05).The amplitude and velocity of geniohyoid muscle movement increased gradually,while the movement time decreased gradually before treatment,2 weeks after treatment and after cure(all P<0.01).The ultrasonic parameters of the geniohyoid muscle were all significantly different between each 2 time points(all P<0.01)except for amplitude of the geniohyoid muscle movement 2 weeks of treatment and after cure(P=0.66).Conclusion Ultrasound could be used to quantitatively assess parameters of geniohyoid muscle movement,therefore providing references for rehabilitation of patients with post-stroke dysphagia.