舌骨运动与食管上括约肌开放程度的相关性研究

郭鹏飞; 李进让

doi:10.13201/j.issn.1001-1781.2015.11.004

舌骨运动与食管上括约肌开放程度的相关性研究

郭鹏飞^1,2,
李进让^2, ,

- 1. 南方医科大学第三临床医学院(广州, 510630);
- 2. 海军总医院全军耳鼻咽喉头颈外科中心

详细信息

通讯作者: 李进让,E-mail:entljr@sina.com

中图分类号: R333.1

收稿日期: 2015-01-27

To study the correlation between hyoid movement and openness of upper esophageal sphincter

GUO Pengfei^1,2,
LI Jinrang^2, ,

- 1. Third Clinical Medical College of Southern Medical University, Guangzhou, 510630, China;
- 2. Department of Otorhinolaryngology Head and Neck Surgery, Navy General Hospital, Beijing

More Information

Corresponding author: LI Jinrang, E-mail: entljr@sina.com

Received Date: 27 January 2015

摘要

摘要: 目的:探讨年龄对吞咽过程中舌骨运动及食管上括约肌(UES)开放程度的影响,并进一步研究舌骨运动与UES开放程度的相关性。方法:对20~74岁的100例健康成人志愿者行X线动态吞咽造影检查,并按年龄分为青年组(<45岁)、中年组(45~65岁)、老年组(>65岁)。然后通过Avidemux 2.5计时软件及Image J图像测量软件测量计算在吞咽过程中舌骨运动的时间、移动距离及UES最大开放程度。结果:在100例志愿者中,舌骨从静止位置运动到最大位移处所用的时间随着年龄的增加逐渐延长,青年组、中年组、老年组之间差异有统计学意义(P<0.05);舌骨在最大位移处停留的时间随着年龄的增加逐渐缩短,青年组与老年组之间、中年组与老年组之间差异有统计学意义(P<0.05);舌骨前移的距离随着年龄的增加逐渐减小,青年组分别与中年组和老年组比较差异均有统计学意义(P<0.05);UES最大开放程度随着年龄的增加而减小,且青年组与老年组之间差异有统计学意义(P<0.05)。UES开放程度与舌骨上移幅度在3组间均无相关性(P>0.05),而UES开放程度与舌骨前移幅度在不同年龄段均显著相关(P<0.05)。结论:吞咽中舌骨运动的时间和空间的相关参数以及UES的最大开放程度在不同年龄组存在差异,舌骨前移和UES开放显著相关(P<0.05)。
- 吞咽 /
- 舌骨 /
- 食管上括约肌
Abstract: Objective:To discuss the effect of age on hyoid movement and the openness of UES in swallowing process, and to investigate the correlation between hyoid movement and openness of UES.Method:The X-ray dynamic swallowing videofluoroscopy was performed on 100 healthy adult volunteers(20-74 years).They were divided into three groups:young (ages 20 to 45), middle-aged (45 to 65) and older (65 and up). Then the software Avidemux 2.5 and Image J were used to measure the time and distance of hyoid movement, and the maximal opening of the UES in swallowing process. Result:The time of hyoid moving to the maximal displacement was delayed along with the ages, and there were significant differences among the three groups (P<0.05). The staying time of hyoid in the maximal displacement gradually shortened along with the ages, and there was significant difference between young and older group, so was the middle-aged and older group(P<0.05). The maximum antedisplacement of hyoid decreased with age, and significant differences were found between young and the middle-aged group and between young and older group (P<0.05). The maximal degree of UES opening decreased with the increase of age, and significant difference was found between young and older group (P<0.05). The upper displacement of hyoid was not related to UES opening(P>0.05), however, the antedisplacement of hyoid had significant relation to UES opening in the three groups (P<0.05).Conclusion:In swallowing process, the time and space parameters of hyoid movement and the maximal degree of UES opening were related to age. There was significant difference between the antedisplacement of hyoid and the openness of UES (P<0.05).
- deglutition /
- hyoid bone /
- upper esophageal sphincter

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参考文献(16)

[1]	TIBBLING L,GUSTAFSSON B.Dysphagia and its consequences in the elderly[J].Dysphagia,1991,6:200-202.
[2]	LINDGREN S,JANZON L.Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population[J].Dysphagia,1991,6:187-192.
[3]	KIM Y,MCCULLOUGH G H.Maximum hyoid displacement in normal swallowing[J].Dysphagia,2008,23:274-279.
[4]	PAIK N J,KIM S J,LEE H J,et al.Movement of the hyoid bone and the epiglottis during swallowing in patients with dysphagia from different etiologies[J].J Electromyogr Kinesiol,2008,18:329-335.
[5]	LOGEMANN J A,PAULOSKI B R,RADEMAKER A W,et al.Oropharyngeal swallow in younger and older women:videofluoroscopic analysis[J].J Speech Lang Hear Res,2002,45:434-445.
[6]	LOGEMANN J A,PAULOSKI B R,RADEMAKER A W,et al.Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men[J].J Speech Lang Hear Res,2000,43:1264-1274.
[7]	YABUNAKA K,SANADA H,SANADA S,et al.Sonographic assessment of hyoid bone movementduring swallowing:a study of normal adults with advancing age[J].Radiol Phys Technol,2011,4:73-77.
[8]	KENDALL K A,LEONARD R J.Hyoid movement during swallowing in older patients with dysphagia[J].Arch Otolaryngol Head Neck Surg,2001,127:1224-1229.
[9]	PARK J W,KIM Y,OH J C,et al.Effortful swallowing training combined with electrical stimulation in post-stroke dysphagia:a randomized controlled study[J].Dysphagia,2012,27:521-527.
[10]	LEONARD R J,KENDALL K A,MCKENZIE S,et al.Structural displacements in normal swallowing:a videofluoroscopic study[J].Dysphagia,2000,15:146-152.
[11]	ISHIDA R,PALMER J B,HIIEMAE K M.Hyoid motion during swallowing:factors affecting forward and upward displacement[J].Dysphagia,2002,17:262-272.
[12]	NAKANE A,TOHARA H,OUCHI Y,et al.Videofluoroscopic kinesiologic analysis of swallowing:defining a standard plane[J].J Med Dent Sci,2006,53:7-15.
[13]	WANG T G,CHANG Y C,CHEN W S,et al.Reduction in hyoid bone forward movement in irradiated nasopharyngeal carcinoma patients with dysphagia[J].Arch Phys Med Rehabil,2010,91:926-931.
[14]	HIRAI H,OMURA K,HARADA H,et al.Sequential evaluation of swallowing function in patients with unilateral neck dissection[J].Head Neck,2010,32:896-904.
[15]	李宁,李进让,孙建军,等.健康成年人咽部吞咽功能客观参数的测量[J].中华耳鼻咽喉头颈外科杂志,2012,47(11):884-888.
[16]	CHI-FISHMAN G,SONIES B C.Effects of systematic bolus viscosity and volume changes on hyoid movement kinematics[J].Dysphagia,2002,17:278-287.