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一项关于吞咽姿势对肺容积分数和呼吸与非营养性吞咽反射之间协调性影响的初步研究。

The pilot study examining the effects of swallowing position on lung volume fraction and the coordination between respiration and non-nutritive swallowing reflex.

机构信息

Department of Special Care Dentistry, Nagasaki University Hospital of Medicine and Dentistry, Nagasaki, Japan.

Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

出版信息

Clin Exp Dent Res. 2020 Jun;6(3):296-304. doi: 10.1002/cre2.274. Epub 2020 Feb 17.

Abstract

BACKGROUND

Body position might affect the coordination between respiration and swallowing. This study was carried out to test the hypothesis that during swallowing, coordinated movements of muscle groups such as the diaphragm and rectus abdominis muscles are important to control normal swallowing apnea.

OBJECTIVE

To investigate this hypothesis, respiratory parameters, swallowing apnea and muscle activity were measured in each of four body positions: sitting position with feet on the floor, 30° reclining position, lateral position, and standing position.

METHODS

All measurements were performed in nine healthy subjects. Nasal airflow was measured using a pneumotachometer and muscle activity was measured using an electromyograph. All lung volume fraction parameters were measured using spirometer and swallowing apnea time was calculated.

RESULTS

The maximum inspiratory volume was 2.76 ± 0.83 L in the 30° reclining position, which was significantly larger than that in the other positions (p = .0001). The preliminary expiratory volume was 1.05 ± 0.42 L in the 30° reclining position, which was significantly smaller than that in the other positions (p < .0001). The swallowing apnea time during water swallowing was 1.17 ± 0.35 sec in the lateral position and 0.87 ± 0.28 sec in the 30° reclining position, which tended to be longer than the 0.78 sec in the sitting position.

CONCLUSION

We conclude that both lateral and reclining positions require a longer period of swallowing apnea compared to the sitting and standing positions. Differences in body position may significantly influence the coordination between respiration and swallowing.

摘要

背景

体位可能会影响呼吸和吞咽之间的协调性。本研究旨在验证假设,即在吞咽过程中,膈肌和腹直肌等肌肉群的协调运动对于控制正常吞咽暂停是重要的。

目的

为了验证这一假设,本研究在四种体位下(脚放在地板上的坐姿、30°仰卧位、侧卧位和站立位)分别测量了呼吸参数、吞咽暂停和肌肉活动。

方法

所有测量均在 9 名健康受试者中进行。使用呼吸流速仪测量鼻气流,使用肌电图测量肌肉活动。使用肺活量计测量所有肺容积参数,并计算吞咽暂停时间。

结果

30°仰卧位时的最大吸气量为 2.76±0.83 L,明显大于其他体位(p=0.0001)。30°仰卧位时的初步呼气量为 1.05±0.42 L,明显小于其他体位(p<0.0001)。在侧卧位和 30°仰卧位时,水吞咽的吞咽暂停时间分别为 1.17±0.35 秒和 0.87±0.28 秒,与 0.78 秒的坐姿相比,时间更长。

结论

我们的结论是,与坐姿和站姿相比,侧卧位和仰卧位都需要更长的吞咽暂停时间。体位的差异可能会显著影响呼吸和吞咽之间的协调性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06dd/7301395/a970d0aa5000/CRE2-6-296-g001.jpg

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