脑卒中后偏瘫患者吞咽功能与膈肌运动的相关性

Correlation between swallowing function and diaphragm movement in patients with hemiplegia after stroke

目的分析脑卒中后偏瘫患者吞咽功能与膈肌运动的相关性。方法采用标准吞咽功能评价量表(SSA)评估51例脑卒中后偏瘫患者的吞咽功能。其中,吞咽障碍31例(吞咽障碍组),非吞咽障碍20例(非吞咽障碍组)。采用超声测定膈肌功能,分析SSA评分与膈肌运动的相关性。结果吞咽障碍组患侧膈肌活动度、呼气末膈肌厚度、膈肌增厚率低于非吞咽障碍组(P<0.05)。吞咽障碍组SSA评分与患侧膈肌活动度、呼气末膈肌厚度和膈肌增厚率呈负相关(r=-0.72、-0.67和-0.55,P<0.05)。结论脑卒中后偏瘫患者吞咽功能可能与膈肌运动密切相关,患侧膈肌活动度越差,吞咽功能越差。

Objective To analyze the correlation between the swallowing function and diaphragm movement in the patients with hemiplegia after stroke.Methods The swallowing function was assessed by standardized swallowing assessment(SSA)in 51 patients with hemiplegia after stroke,of whom 31 cases with dysphagia(group A)and 20 cases without dysphagia(group B).The diaphragmatic function was measured by ultrasound.The correlation between SSA score and diaphragm movement was analyzed.Results The diaphragmatic activity on the affected side,end-expiratory diaphragmatic thickness and diaphragmatic thickening rate were lower in group A than those in group B(P<0.05).SSA score of group A was negatively correlated with diaphragmatic activity on the affected side,end-expiratory diaphragmatic thickness and diaphragmatic thickening rate(r=-0.72,-0.67 and-0.55,P<0.05).Conclusion The swallowing function is closely related to diaphragm movement in the patients with hemiplegia after stroke.The worse the movement of the affected diaphragm,the worse the swallowing function.