Aii Seijiro, Fujishima Ichiro, Shigematsu Takashi, Ohno Tomohisa, Kunieda Kenjiro, Yamawaki Masanaga
Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wagokita, Chuo-Ku, Hamamatsu City, Shizuoka, 433-8511, Japan.
Department of Medical Education Research and Development, Graduate School of Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan.
Dysphagia. 2024 Oct;39(5):940-947. doi: 10.1007/s00455-024-10674-6. Epub 2024 Apr 3.
Texture modification in the form of gels or jellies is used for patients with dysphagia. For over 20 years, our group has been using gelatin jellies, a type of gel, as a starting diet for patients with dysphagia. Gelatin jellies are served in a small-sliced form and swallowed whole. In sliced jelly whole swallowing (SJWS), sliced gelatin jelly (SGJ) passes through the pharynx in one lump without collapsing. This study aimed to examine the usefulness of SJWS. We analyzed the images of videofluoroscopic swallowing studies performed using the normalized residue ratio scale (NRRSv: vallecula, NRRSp: pyriform sinus), the penetration-aspiration scale (PAS), and pharyngeal transit time (PTT) in 50 patients with dysphagia and compared the results in a prospective study. SJWS had significantly less residue in both NRRSv and NRRSp than in moderately thickened liquid swallowing. No significant differences in PAS scores were found between SGJ and moderately thickened liquid. Additionally, no significant differences in PTT scores were noted between the two. This study demonstrated the usefulness of SJWS in improving swallowing safety in patients with dysphagia. Further studies are needed to evaluate the reproducibility of the test, the comparison of SGJ with other thickened liquids, and the safety of SJWS for different diseases.
以凝胶或果冻形式进行的质地改良用于吞咽困难患者。20多年来,我们团队一直将明胶果冻(一种凝胶)作为吞咽困难患者的初始饮食。明胶果冻以薄片形式提供,整粒吞咽。在切片果冻整粒吞咽(SJWS)中,切片明胶果冻(SGJ)整块通过咽部而不塌陷。本研究旨在检验SJWS的有效性。我们分析了50例吞咽困难患者使用标准化残留率量表(NRRSv:会厌谷,NRRSp:梨状窦)、渗透-误吸量表(PAS)和咽部通过时间(PTT)进行的视频荧光吞咽造影研究图像,并在前瞻性研究中比较了结果。SJWS在NRRSv和NRRSp中的残留均明显少于吞咽中度增稠液体时。SGJ和中度增稠液体之间的PAS评分无显著差异。此外,两者之间的PTT评分也无显著差异。本研究证明了SJWS在提高吞咽困难患者吞咽安全性方面的有效性。需要进一步研究来评估该测试的可重复性、SGJ与其他增稠液体的比较以及SJWS对不同疾病的安全性。