Kim Il Soo, Han Tai Ryoon
Department of Rehabilitation Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Arch Phys Med Rehabil. 2005 Oct;86(10):1986-90. doi: 10.1016/j.apmr.2005.05.004.
To determine differences of the oral swallowing functions between stroke and normal subjects and to identify those factors affecting dysphagia of stroke patients.
Case-control study.
University hospital.
Ten stroke and 10 healthy subjects.
Not applicable.
Resting saliva flow rate, the total number of chews, and the duration of the oral phase until onset of pharyngeal swallow, and food viscosities both before and after the oral phase using diluted barium, pudding, thick rice gruel, and curd type yogurt.
The viscosity of all test foods was significantly reduced after the oral phase in both groups (P<.01). Resting saliva flow rate and the viscosity of thick rice gruel after the oral phase in the stroke group were significantly lower than in the control group (P<.01). However, there were no differences in the viscosities of the other foods between both groups. And a longer oral phase and a greater number of chews prior to pharyngeal swallow were revealed in the stroke group than in the control group (P<.01).
This study shows that the food requiring mastication demands a longer oral phase and a greater number of chews, and has more altered rheologic characteristics during the oral phase in stroke patients. These findings suggest that masticatory function is impaired in stroke patients, which may contribute to their swallowing dysfunction.
确定中风患者与正常受试者口腔吞咽功能的差异，并找出影响中风患者吞咽困难的因素。
病例对照研究。
大学医院。
10名中风患者和10名健康受试者。
不适用。
静息唾液流速、咀嚼总次数、直至咽吞咽开始的口腔期持续时间，以及使用稀释钡剂、布丁、稠米粥和凝乳型酸奶在口腔期前后的食物黏度。
两组中所有测试食物在口腔期后的黏度均显著降低（P<0.01）。中风组的静息唾液流速和口腔期后稠米粥的黏度显著低于对照组（P<0.01）。然而，两组之间其他食物的黏度没有差异。并且中风组在咽吞咽前的口腔期比对照组更长，咀嚼次数更多（P<0.01）。
本研究表明，需要咀嚼的食物在中风患者的口腔期需要更长的时间和更多的咀嚼次数，并且在口腔期具有更多改变的流变学特征。这些发现表明中风患者的咀嚼功能受损，这可能导致他们的吞咽功能障碍。
