以自製吞嚥動作儀評估食團溫度、體積及黏稠度對吞嚥功能的影響：先期研究

The Influence of Bolus Volume, Temperature, and Viscosity to Swallowing Function by a Self-designed Phagometer: A Preliminary Study

李志明(Chih-Ming Li) ； 李明峰(Ming-Feng Li) ； 郭柏齡(Po-Lin Kuo) ； 王亭貴(Tyng-Guey Wang) ； 連倚南(I-Nan Lien)

《中華民國復健醫學會雜誌》 31卷2期 (2003/06) Pp. 79-86

摘要

本研究是以自製吞嚥動作儀偵測舌下肌及咽喉的動作，據此推測吞嚥功能並探討食團溫度、黏稠度及體積對吞嚥功能的影響。共有10名健康男性接受本測驗，所有受試者過去都沒有吞嚥障礙的病史，其平均年齡為26.3±5.7歲。檢查是以一個頸圈為架構，接上微動開關以偵測受試者之舌下肌肉及咽喉動作，並計算出食團通過舌頭後至咽喉上舉的時間，定為吞嚥激發時間。檢查時，受試者依序吞入1cc,5cc,10cc及20cc 25℃的溫水； 5cc 0℃冰水； 及以150cc、100cc及75cc水分別加進4.3克快凝寶之溶液各5cc，記錄其吞嚥激發時間。研究結果顯示，進食5cc 25℃之溫水時，吞嚥激發時間為358.4±70.5msec，隨著食團體積增加，吞嚥激發時間並沒有明顯改變；但吞食0℃冰水時，吞嚥激發時間縮短為311.6±56.3msec，具統計上差異；而不同黏稠度的溶液並不會改變吞嚥激發時間。
我們認為以自製之吞嚥動作儀可偵測出食團經過舌頭推擠到引發吞嚥反射的時間，以當作評估吞嚥功能的參數，發現冰水是加速吞嚥反射的有效因子。

關鍵字

吞嚥障礙 ； 吞嚥激發時間 ； 吞嚥動作儀 ； 溫度刺激

並列摘要

”The study aimed to depict the influence of bolus temperature, volume, and viscosity in swallowing function by a self-designed phagometer. Two micro switches were used to detect submental muscle activity and pharyngeal motion. They were anchored on a posterior-type cervicothoracic orthosis with multiple adjustable joints to ensure the well contact between the switch and the skin. The signals detected by micro switches were amplified and recorded. The duration between two waves was defined as swallowing trigger time and used to represent the swallowing function.
Ten normal male subjects without clinical evidence of dysphagia were enrolled in this study. The average age of the subjects was 26.3 ± 5.7 years old. The subjects were asked to swallow 1 cc, 5cc, 10 cc and 25cc of 25°C water respectively. 5cc of Q°C ice water and 5 cc of low consistency, medial consistency, as well as high consistency mediums were then swallowed consequently. The subjects had adequate rest between each swallow. The results showed that the trigger time of swallowing 5ce 25°C water was 358.4 ± 70.5 msec and it reduced as bolus volume increased without statistical significance. The trigger time of swallowing O°C water significantly reduced to 311.6:t 56.3 msec. Different consistency of bolus did not influence the trigger time of swallowing.
We concluded that the self-designed phagometer can objectively evaluate the swallowing function and ice water may be effective in facilitating the swallowing.”

並列關鍵字

dysphagia ； trigger time ； phagometer ； thermal stimulation