Evaluating Method for Swallowing Function-Influence of Posture for Swallowing

目的：建立一种客观的吞咽功能评价方法。方法：选择10名健康、全齿男性，平均年龄(29.5±3.6)岁。采用通用超声诊断仪，5 MHz电子凸扇形扫描探头，观察吞咽试验食物时的舌动情况。为了记录吞咽声，心音麦克风通过生理信号单元连接到超声诊断设备。舌动和吞咽音同时记录在记录纸上，并用数字化仪绘出运动曲线的5个拐点(T1、T2、T3、T4和T5)和吞咽音的两个起点(S1和S2)进行分析。受试者被指示以3种身体姿势吞咽试验食物(一种混合了水的淀粉化合物)；直立坐在牙科椅子上，以300度的角度倾斜在牙科椅子上，完全倾斜…在牙科椅子上有更多的位置。同时，对5例健康、全齿男性直立位行X线摄像，同时记录回声图像和吞咽声。结果：10例受试者的数据均具有可重复性。T_4与Si、T_4与S_2呈显著正相关(p&lt；0.001)。SI总是领先于T4。在完全卧位时，从吞咽开始到T_3、T_4、S_1和S_2的时间显著延长(p&lt；0.05)，从T_3到T_4的时间也显著延长(p&t；0.05)。T_4与S_1在统计学上有显著相关性(P&lt；0.05)。结论：本研究建立的评估方法可用于吞咽障碍的诊断。较少

Objectives:The purpose of this study was to develop an objective evaluation method for swallowingMethods:Ten healthy, fully dentate males (average age: 29.5 ± 3.6 years old) were selected as subjects. To observe tongue movements in swallowing the test food, general-purpose ultra-sound diagnostic equipment was used with a 5 MHz electronic convex sector scanning probe. To record swallowing sounds, a heart sound microphone was connected to the ultra-sound diagnostic equipment through a physiologic signal unit. The tongue movements and swallowing sounds were simultaneously recorded on recording paper and analyzed by plotting five inflection points (T1, T2, T3, T4 and T5) of the movement curve and two beginning points of swallowing sounds (S1 and S2) using a digitizer. Subjects were directed to swallow the test food (a starch compound mixed with water) with 3 bodily positions; sitting in upright position in the dental chair, reclining at a 300 angle in the dental chair, a complete reclining … More position in the dental chair. Also, X-ray images by a videofluorography were recorded simultaneously with echo images and swallowing sounds in five healthy, fully dentate males in upright position.Results:It was confirmed that all the data of 10 subjects had repeatability. There was statistically significant correlation between T4 and Si, T4 and S2 (p<0.001), respectively. Si were always ahead of T4. From the VF-image, Si coincided with the point of time that the epiglottis was just going to shut, and T4 coincided with the point of time that the tail of test food has just got to the esophagus.In the complete reclining position, time from the starting point of swallowing to T_3, T_4, S_1 and S_2 were significantly extended (p<0.05), and time from T_3 to T_4 was also significantly extended (p<0.05). There was a significantly correlation between T_4 and S_1, statistically (p<0.05).Conclusion:From this investigation, it is suggested that our evaluation method could be useful for the diagnosis of swallowing. Less