Ismael-Mohammed Kovan, Bolivar-Prados Mireia, Laguna Laura, Lara Adrian Nuñez, Viñas Paula, Cera Marta, Clavé Pere
Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.
Institute of Agrochemistry and Food Technology (IATA, CSIC), Valencia, Spain.
J Texture Stud. 2025 Mar;56(2):e70017. doi: 10.1111/jtxs.70017.
The therapeutic effect and optimal rheological properties of thick purees for hospitalized patients with oropharyngeal dysphagia (OD) have not yet been settled.
The objectives of this study were to (a) Quantify the rheological properties of 6 thick purees Texture C, BDA; (b) Determine the biomechanics of oral processing and its effect on the rheological properties; (c) Evaluate the safety and efficacy of swallowing the purees in patients with OD.
Six pureed dishes (30 g) were given to 20 patients with OD aged 84 ± 7.2 years. Oral processing was measured using electromyography. Rheological and textural properties were analyzed before and after oral processing using a rheometer and texture analyzer. The safety and efficacy of swallowing were evaluated using the Volume-Viscosity Swallow Test (V-VST).
All dishes met Texture C BDA. Basal shear viscosity at 50s-1 ranged from 1200 to 2200 mPa·s; maximum force, 0.47-0.67 N; cohesiveness, 0.73-0.82; and adhesiveness, 0.77-1.1 N·s. Oral processing reduced shear viscosity and maximum force without altering cohesiveness. To achieve bolus ready-to-swallow, 17-20 mastication cycles (MC) and 15-22 s at 0.98-1.44 MC/S frequency were needed. All purees were significantly safer to swallow (98%-100%) compared to thin liquids (87%) (p < 0.001) and 250 mPa·s nectar fluids (94% p < 0.008). Oral residue prevalence increased to 28% and pharyngeal residue to 21% for purees. Palatability resulted in 40%-60% liking all dishes.
This study shows that thick purees within a viscosity range of 1200-2200 mPa·s are a safe treatment for nutritional support for most hospitalized older patients with oropharyngeal dysphagia.
浓稠均质食物对于患有口咽吞咽困难（OD）的住院患者的治疗效果及最佳流变学特性尚未确定。
本研究的目的是：（a）量化6种浓稠均质食物（质地C、BDA）的流变学特性；（b）确定口腔加工的生物力学及其对流变学特性的影响；（c）评估OD患者吞咽这些均质食物的安全性和有效性。
给20名年龄为84±7.2岁的OD患者提供6份（每份30克）均质食物。使用肌电图测量口腔加工过程。在口腔加工前后，使用流变仪和质地分析仪分析流变学和质地特性。使用容量-粘度吞咽测试（V-VST）评估吞咽的安全性和有效性。
所有食物均符合质地C BDA标准。50s-1时的基础剪切粘度范围为1200至2200mPa·s；最大力为0.47-0.67N；内聚性为0.73-0.82；粘附性为0.77-1.1N·s。口腔加工降低了剪切粘度和最大力，而不改变内聚性。为使食团达到可吞咽状态，需要17-20次咀嚼循环（MC），频率为0.98-1.44MC/S时需15-22秒。与稀液体（87%）（p<0.001）和250mPa·s的花蜜状液体（94%，p<0.008）相比，所有均质食物吞咽起来明显更安全（98%-100%）。均质食物的口腔残留发生率增至28%，咽部残留发生率增至21%。食物的适口性使40%-60%的患者喜欢所有食物。
本研究表明，粘度范围在1200-2200mPa·s的浓稠均质食物对于大多数患有口咽吞咽困难的住院老年患者来说是一种安全的营养支持治疗方法。
