Inokuchi Haruhi, Brodsky Martin B, González-Fernández Marlís, Yoda Mitsumasa, Hiraoka Takashi, Matsuo Koichiro, Palmer Jeffrey B
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA,
Dysphagia. 2014 Dec;29(6):685-91. doi: 10.1007/s00455-014-9562-5. Epub 2014 Aug 21.
Stage II transport (St2Tr) is propulsion of triturated food into the pharynx for storage before swallowing via tongue squeeze-back against the palate. To clarify the phenomenology of St2Tr, we examined the effects of food consistency and the number of chewing cycles on the number of St2Tr cycles in a chew-swallow sequence. We recorded chew-swallow sequences in lateral projection with videofluoroscopy of 13 healthy volunteers eating 6 g of hard (shortbread cookie), and soft foods (ripe banana and tofu) with barium. We counted the number of chewing and St2Tr cycles from food intake to terminal swallow. We used the Friedman test for bivariate analyses and negative binomial regression for multivariable analyses. On bivariate analysis, food consistency had a positive association with the number of chewing cycles (P = 0.013), but not with the number of St2Tr cycles (P = 0.27). Multivariable analysis, however, revealed a greater number of St2Tr cycles with hard than soft food (P ≤ 0.01) and a trend toward negative correlation between the numbers of St2Tr and chewing cycles (P = 0.083). The number of chewing cycles needed to clear the mouth differs among food consistencies as demonstrated previously. Greater numbers of both St2Tr and chewing cycles were elicited with the hard than with the soft foods. Given the trend toward negative correlation, the association between the number of St2Tr cycles and that of chewing cycles deserves further study.
第二阶段运输(St2Tr)是指在吞咽前,通过舌头向后挤压抵住上颚,将磨碎的食物推进咽部进行储存。为了阐明St2Tr的现象学,我们研究了食物质地和咀嚼次数对咀嚼-吞咽序列中St2Tr次数的影响。我们对13名健康志愿者进行了视频荧光透视侧位记录,他们食用了6克含钡的硬食物(酥饼)、软食物(成熟香蕉和豆腐),记录从摄入食物到最终吞咽的咀嚼和St2Tr次数。我们使用弗里德曼检验进行双变量分析,使用负二项回归进行多变量分析。双变量分析显示,食物质地与咀嚼次数呈正相关(P = 0.013),但与St2Tr次数无关(P = 0.27)。然而,多变量分析显示,硬食物比软食物的St2Tr次数更多(P≤0.01),并且St2Tr次数与咀嚼次数之间存在负相关趋势(P = 0.083)。如先前所示,清除口腔所需的咀嚼次数因食物质地而异。硬食物比软食物引发的St2Tr和咀嚼次数都更多。鉴于存在负相关趋势,St2Tr次数与咀嚼次数之间的关联值得进一步研究。