Kim S J, Han T R, Kwon T K
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Thorac Cardiovasc Surg. 2010 Mar;58(2):108-12. doi: 10.1055/s-0029-1186278. Epub 2010 Mar 23.
Aim of the study was to investigate the swallowing kinematics of patients with dysphagia which developed after pneumonectomy.
We investigated the swallowing kinematics of patients with dysphagia development after pneumonectomy and compared them with age- and gender-matched normal controls. The following swallowing parameters were compared: (1) maximum anterior and superior displacement (mm) of the hyoid bone; (2) maximum anterior and superior displacement (mm) of the larynx; (3) maximum epiglottic rotation angle ( degrees ); and (4) pharyngeal delay time (PDT) (sec) using videofluoroscopy.
Significant differences were found in the maximum superior displacement of the hyoid bone ( P = 0.028) and larynx ( P = 0.001). Pharyngeal delay time showed a significant difference between the two groups ( P = 0.001). When we dichotomized patients to vocal cord palsy and non-palsy subgroups, no significant difference was found in all parameters.
Our results indicate that dysphagia development after pneumonectomy is characterized by reduced hyolaryngeal elevation during swallowing and delay of the pharyngeal swallowing reflex. Further study must be done to reveal the exact mechanism of this phenomenon.
本研究旨在调查肺切除术后发生吞咽困难患者的吞咽运动学。
我们调查了肺切除术后发生吞咽困难患者的吞咽运动学,并将其与年龄和性别匹配的正常对照组进行比较。比较了以下吞咽参数:(1)舌骨的最大向前和向上位移(毫米);(2)喉的最大向前和向上位移(毫米);(3)会厌最大旋转角度(度);以及(4)使用电视荧光吞咽造影术测量的咽部延迟时间(PDT)(秒)。
舌骨的最大向上位移(P = 0.028)和喉的最大向上位移(P = 0.001)存在显著差异。两组之间的咽部延迟时间存在显著差异(P = 0.001)。当我们将患者分为声带麻痹和非麻痹亚组时,所有参数均未发现显著差异。
我们的结果表明,肺切除术后吞咽困难的发生特点是吞咽过程中舌骨和喉的抬高减少以及咽部吞咽反射延迟。必须进一步研究以揭示这种现象的确切机制。