Lan Yue, Xu Guangqing, Dou Zulin, Lin Tuo, Yu Fan, Jiang Lisheng
*Department of Rehabilitation Medicine, The Third Affiliated Hospital †Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
J Clin Gastroenterol. 2015 Jan;49(1):24-30. doi: 10.1097/MCG.0000000000000100.
The objective of the current study was to examine the correlation between high-resolution manometric and videofluoroscopic measurements of the swallowing function.
In such cases in which manometric analysis is not feasible, it would be ideal if information regarding pressure during swallowing could be inferred from a videofluoroscopic swallowing study (VFSS) evaluation alone.
The swallowing function was examined using simultaneous VFSS and high-resolution manometry (HRM) in 24 brainstem stroke survivors with dysphagia. The pharyngeal constriction ratio (PCR) and upper esophageal sphincter (UES) maximum opening diameter were measured using VFSS digital analysis. The pharyngeal maximum pressure and UES residual pressure were measured using HRM. The correlation coefficients between the PCR and pharyngeal maximum pressure and between the UES maximum opening diameter and UES residual pressure were calculated. The Spearman analyses were used to calculate the correlation coefficients between manometric and fluoroscopic parameters.
The increase in the pharyngeal maximum pressure wave amplitude was significantly correlated with a decrease in the PCR (r=-0.849, P<0.001). The increase in the UES opening diameter was significantly correlated with a decrease in the UES residual pressure (r=-0.705, P<0.001). High space-time correlations between the pressure and kinematics of swallowing-related structures were obtained using simultaneous manometric and videofluoroscopic measurements.
Certain VFSS measures are significantly correlated with measures of pressure assessed using HRM. The measures may be used as indicators of possible pressure deficits of swallowing.
本研究的目的是检验吞咽功能的高分辨率测压与视频荧光吞咽测量之间的相关性。
在测压分析不可行的情况下,如果仅通过视频荧光吞咽研究(VFSS)评估就能推断出吞咽时的压力信息,那就再好不过了。
对24名患有吞咽困难的脑干中风幸存者同时进行VFSS和高分辨率测压(HRM)以检查吞咽功能。使用VFSS数字分析测量咽缩窄率(PCR)和食管上括约肌(UES)最大开口直径。使用HRM测量咽部最大压力和UES残余压力。计算PCR与咽部最大压力之间以及UES最大开口直径与UES残余压力之间的相关系数。使用Spearman分析计算测压参数与荧光透视参数之间的相关系数。
咽部最大压力波幅的增加与PCR的降低显著相关(r = -0.849,P <0.001)。UES开口直径的增加与UES残余压力的降低显著相关(r = -0.705,P <0.001)。通过同时进行测压和视频荧光吞咽测量,获得了吞咽相关结构的压力与运动学之间的高时空相关性。
某些VFSS测量结果与使用HRM评估的压力测量结果显著相关。这些测量结果可作为吞咽可能存在压力不足的指标。