不同增稠剂对口咽期吞咽障碍患者渗漏误吸的影响

关键词：吞咽障碍  渗漏  误吸  增稠剂

Keywords:dysphagia  penetration  aspiration  thickener

摘要：

      摘要 目的：探讨淀粉类增稠剂、黄原胶类增稠剂及凝胶类增稠剂对口咽期吞咽障碍患者渗漏误吸的影响。 方法：选取20例口咽期吞咽障碍患者进行吞咽造影检查(videofluoroscopic swallowing study， VFSS)，患者随机顺序进食分别由淀粉类增稠剂、黄原胶类增稠剂及凝胶类增稠剂调制的高度稠/细泥型造影剂，观察患者的吞咽功能及不同增稠剂对其渗漏误吸情况的影响，并采用Rosenbek渗漏-误吸分级记录。 结果：黄原胶类组与淀粉类组的渗漏误吸分级比较，及凝胶类组与淀粉类组的渗漏误吸分级比较，差异均具有显著性意义。 结论：黄原胶类增稠剂及凝胶类增稠剂改善口咽期吞咽障碍患者渗漏误吸情况的效果优于淀粉类增稠剂，临床应用时应根据患者的误吸风险及吞咽能力更个体化地选择合适的增稠剂。

Abstract:

      Abstract Objective:To investigate the effects of starch thickener， xanthan gum thickener and gel thickener on penetration and aspiration in patients with oropharyngeal dysphagia. Method:Twenty patients with oropharyngeal swallowing disorder were performed videofluoroscopic swallowing study(VFSS). Patients were given extremely thick/pureed contrast agents made of starch thickener， xanthan gum thickener or gel thickener in a random order to observe the swallowing function and the influence of different thickeners by assessing Rosenbek penetration aspiration scale (PAS) . Result:The difference between xanthan gum group and starch group， and the difference between gel group and starch group were statistically significant. Conclusion:Xanthan gum thickener and gel thickener can both decrease the incidence rate of penetration and aspiration of patients with oropharyngeal dysphagia， which is better than starch thickener. The appropriate thickener should be selected according to the patient's risk of aspiration and swallowing ability.