Department of Rehabilitation Medicine, Jikei University School of Medicine, Tokyo, Japan.
J Stroke Cerebrovasc Dis. 2013 Apr;22(3):267-70. doi: 10.1016/j.jstrokecerebrovasdis.2011.08.009. Epub 2011 Oct 2.
Our objective was to determine the texture of semisolid foods that are appropriate for poststroke dysphagic patients.
Subjects included 52 poststroke dysphagic patients (72 ± 8 years of age) who were trained with semisolid foods and required the evaluation of swallowing function. Fifty-two homogeneous semisolid foods not requiring mastication were given. Texture were measured twice using a rheometer (TPU-2S; Yamaden Co. Ltd., Tokyo, Japan). Texture characteristics were as follows: hardness, 1873 to 19,510 N/m(2) (mean 9,129 N/m(2)); cohesiveness, 0.13 to 0.67 (mean 0.32); adhesiveness, 2 to 878 J/m(3) (mean 209 J/m(3)); and gumminess, 546 to 8781 N/m(2) (mean 2908 N/m(2)). Patients sat during fiberoptic endoscopic evaluation and ingested a single semisolid food. The patients were asked to swallow 4 g of food, and the texture, pharyngeal residue, penetration into the larynx, and aspiration were evaluated. We observed and noted the association between the texture of foods and swallowing movements by videoendoscopy.
Evaluating food texture by endoscopy revealed significant differences in adhesiveness according to residue deposition and significant differences in gumminess according to aspiration.
We identified the textures of different semisolid foods as being either appropriate or inappropriate for poststroke dysphagic patients.
我们的目的是确定适合脑卒中吞咽困难患者的半固态食物质地。
研究对象包括 52 例脑卒中吞咽困难患者（72±8 岁），他们接受了半固态食物的训练，需要评估吞咽功能。共给予 52 种质地均匀、无需咀嚼的半固态食物。使用流变仪（TPU-2S；Yamaden Co. Ltd.，东京，日本）两次测量质地。质地特征如下：硬度为 1873 至 19510 N/m²（平均 9129 N/m²）；稠度为 0.13 至 0.67（平均 0.32）；粘性为 2 至 878 J/m³（平均 209 J/m³）；胶粘性为 546 至 8781 N/m²（平均 2908 N/m²）。患者在纤维内镜评估时坐直并吞下一种单一的半固态食物。要求患者吞下 4 g 食物，评估食物质地、咽部残留物、穿透至喉部和吸入情况。我们通过视频内镜观察并记录食物质地与吞咽运动之间的关系。
通过内镜评估食物质地，发现粘性与残留物沉积有关，胶粘性与吸入有关，差异均有统计学意义。
我们确定了不同半固态食物的质地适合或不适合脑卒中吞咽困难患者。
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