Deglutitive aspiration in patients with tracheostomy: effect of tracheostomy on the duration of vocal cord closure.
Deglutitive aspiration in patients with tracheostomy: effect of tracheostomy on the duration of vocal cord closure.
复制标题
气管切开术患者的吞咽性误吸：气管切开术对声带闭合持续时间的影响。
DOI：
10.1016/0016-5085(95)90682-7
复制
发表时间：
1995
期刊：
影响因子：
29.4
通讯作者：
Hogan,W
中科院分区：
文献类型：
--
作者：
Shaker,R;Milbrath,M;Ren,J;Campbell,B;Toohill,R;Hogan,W
背景/目的气管切开术患者的吞咽误吸可归因于喉运动受损、喉保护性反射丧失和喉关闭不协调。本研究的目的是确定气管切开术对吞咽声带关闭持续时间的影响。方法采用同步视频内窥镜、呼吸图和颏下肌电图，比较气管切开术患者和正常人的吞咽性声带闭合及其与吞咽性呼吸暂停的时间关系。结果组间比较显示，气管切开术患者声带内收/外展时间明显短于正常对照组（P < 0.05）。与正常志愿者相比，气管造瘘患者，5 ml水吞比干咽明显增加声带内收/外展持续时间（P < 0.05）。此外，在气管切开术患者中，吞咽性呼吸暂停和颏下肌电图与声带动力学不协调。结论气管切开术患者吞咽时声带闭合虽完全，但闭合时间明显短于正常人。气管切开术患者吞咽声带动力学、呼吸暂停和颏下肌电图的协调性发生改变。与正常对照相反，气管切开术患者的吞咽声带闭合持续时间因液体丸的存在而改变。
Background/Aims Deglutitive aspiration in patients with tracheostomy has been attributed to impaired laryngeal movement, loss of protective laryngeal reflexes, and uncoordinated laryngeal closure. The aim of this study was to determine the effect of tracheostomy on the duration of deglutitive vocal cord closure. Methods Using concurrent videoendoscopy, respirography, and submental electromyography, deglutitive vocal cord closure and its temporal relationship with deglutitive apnea was compared between patients with tracheostomy and normal volunteers. Results Between-group comparison showed that the duration of vocal cord adduction/abduction in patients with tracheostomy was significantly shorter than that of normal volunteers (P < 0.05). Contrary to normal volunteers, in patients with tracheostomy, 5-mL water swallows significantly increased the duration of vocal cord adduction/abduction compared with that of dry swallows (P < 0.05). In addition, in patients with tracheostomy, deglutitive apnea and submental electromyography were not coordinated with vocal cord kinetics. Conclusions Although the vocal cords close completely during swallowing in patients with tracheostomy, their duration of closure is significantly shorter compared with normal volunteers. Coordination of deglutitive vocal cord kinetics, apnea, and submental electromyography is altered in patients with tracheostomy. Contrary to normal controls, duration of deglutitive vocal cord closure in patients with tracheostomy is modified by the presence of liquid bolus.