Evelyn Trammell Institute for Voice and Swallowing, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Otolaryngology-Head and Neck Surgery and Radiation Oncology, Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA.
Neurogastroenterol Motil. 2017 Dec;29(12). doi: 10.1111/nmo.13144. Epub 2017 Jul 11.
A limitation to the expanded use of high-resolution pharyngeal manometry (HRPM) in clinical practice is the lack of useful pharyngeal parameters that are easy to interpret, generalizable between patients, and do not require specialized software. In this study, we sought to test the relationship between the pharyngeal contractile integral (PhCI) with videofluoroscopic abnormalities as assessed with the Modified Barium Swallow Impairment Profile ™.
Adult dysphagic patients were recruited to undergo simultaneous HRPM and videofluoroscopy during a standardized swallowing protocol.
Thirty-six patients were included in the study. The mean PhCI was 247 mm Hg·cm·s (range 2-488 mm Hg·cm·s). The lower pharyngeal total (PT) group (N=20; mean PT=3.9) had a mean PhCI of 299 mm Hg·cm·s, while the higher PT group (N=16; mean PT=12.7) had a mean PhCI score of 188 mm Hg·cm·s (P=.01). There was also a significant negative correlation between normalized PhCI to PT scores (r=-.47; P=.004). Patients with higher PhCIs exhibited less severe penetration-aspiration scores on thin liquids (1.44 vs 3.78; P=.03) and all consistencies combined (1.21 vs 1.99; P=.03).
CONCLUSIONS & INFERENCES: The PhCI is a useful indicator of the presence of pharyngeal swallowing impairment and is technically simple to calculate with currently available software programs. Advancement of software is necessary to refine the clinical value of this parameter. High-resolution pharyngeal manometry has the potential to be a valuable adjunct procedure for the evaluation and treatment of dysphagic individuals.
高分辨率咽测压（HRPM）在临床实践中的应用受到限制，原因是缺乏易于解释、可在患者之间推广且无需专用软件的有用咽测压参数。本研究旨在检验咽收缩积分（PhCI）与改良钡吞咽障碍影像分析（Modified Barium Swallow Impairment Profile ™）评估的咽运动异常之间的关系。
招募成人吞咽困难患者，让他们在标准化吞咽协议下同时接受 HRPM 和视频透视检查。
本研究共纳入 36 例患者。平均 PhCI 为 247mm Hg·cm·s（范围 2-488mm Hg·cm·s）。下咽部总容积（PT）较小组（N=20；平均 PT=3.9）的平均 PhCI 为 299mm Hg·cm·s，而 PT 较大组（N=16；平均 PT=12.7）的平均 PhCI 为 188mm Hg·cm·s（P=.01）。PhCI 与 PT 评分的归一化值之间也存在显著负相关（r=-.47；P=.004）。PhCI 较高的患者在稀薄液体（1.44 分比 3.78 分；P=.03）和所有一致性物质（1.21 分比 1.99 分；P=.03）中的渗透-误吸评分更低。
PhCI 是咽吞咽障碍存在的有用指标，目前可用的软件程序在技术上易于计算。需要进一步开发软件来完善该参数的临床价值。高分辨率咽测压有可能成为评估和治疗吞咽困难患者的有价值的辅助程序。
