Kim Youngsun, Park Taeok, Oommen Elizabeth, McCullough Gary
From the Communication Sciences and Disorders, Ohio University, Athens (YK, TP); Department of Speech Pathology and Audiology, Calvin College, Grand Rapids, Michigan (EO); and College of Health Sciences, Appalachian State University, Boone, North Carolina (GM).
Am J Phys Med Rehabil. 2015 Sep;94(9):734-9. doi: 10.1097/PHM.0000000000000258.
Timely and efficient upper esophageal sphincter (UES) opening may be critical to safe transport of food or liquid to the stomach and to prevent aspiration during the swallow. The purpose of this study was to examine the temporal and biomechanical characteristics of the UES opening in stroke survivors.
Maximum duration and width of the UES opening were obtained from 15 stroke survivors with aspiration and 15 stroke survivors with no aspiration. The control group was composed of 15 normal subjects undergoing videofluoroscopic swallowing examinations. The videofluoroscopic swallowing examination protocol was as follows: two swallows of 5 ml thin liquid and two swallows of 10 ml thin liquid. Statistical comparisons were made by repeated measurements of analysis of variance, and the significance level was set at P < 0.025.
The stroke survivors with aspiration, the stroke survivors without aspiration, and the control group differed significantly for duration of UES opening (P < 0.01) but not maximum width of UES opening.
Prolonged UES opening may be related to prolonged pharyngeal transition of the bolus and slower UES muscle contraction and hyolaryngeal excursion after stroke.
及时且高效的食管上括约肌（UES）开放对于食物或液体安全输送至胃部以及防止吞咽期间误吸可能至关重要。本研究的目的是检查中风幸存者UES开放的时间和生物力学特征。
从15名有吞咽误吸的中风幸存者和15名无吞咽误吸的中风幸存者中获取UES开放的最长持续时间和最大宽度。对照组由15名接受视频荧光吞咽检查的正常受试者组成。视频荧光吞咽检查方案如下：吞咽两次5毫升稀液体和两次10毫升稀液体。通过重复测量方差分析进行统计比较，显著性水平设定为P < 0.025。
有吞咽误吸的中风幸存者、无吞咽误吸的中风幸存者和对照组在UES开放持续时间上存在显著差异（P < 0.01），但在UES开放最大宽度上无显著差异。
中风后UES开放时间延长可能与食团咽部转运时间延长以及UES肌肉收缩和舌骨下咽运动减慢有关。
