| Objectives 1.Ultrasound was used to measure the parameters of swallowing movement in patients with and without dysphagia after stroke,and to compare the difference between the two,and to evaluate the value of ultrasonography in assessing post-stroke dysphagia;2.Ultrasound was used to measure the parameters of swallowing movement before and after treatment in patients with dysphagia after stroke and to compare the rehabilitation effect of patients with true and pseudobulbar paralysis.To explore the practicality of ultrasound evaluation of dysphagia.Methods The first part: 60 patients with stroke,according to the enrollment conditions,30 patients with dysphagia were recorded as the experimental group,and 30 patients with swallowing function were not counted as the control group.Patients were asked to use air-pharyngeal movement,and the following four aspects were dynamically observed and preserved using ultrasound:(1)lingual muscle thickness and movement: tongue thickness,tongue movement amplitude,exercise time and average speed(the latter three were for M-mode ultrasound)The middle tongue movement curve rises phase);(2)hyoid bone movement: the maximum distance between the hyoid bone and the thyroid cartilage,the minimum distance,the time required,the shortening distance and the shortening rate;the maximum distance between the hyoid bone and the mandible,the minimum distance,The required time,calculate the shortening distance and shortening rate;(3)the pharyngeal sidewall: the amplitude of motion and the time of exercise.All swallowing motion parameters were recorded and the resulting parameters were statistically processed.The second part:Twenty patients with dysphagia after stroke were selected.According to the enrollment conditions,10 patients included 10 cases of true and pseudobulbar paralysis.The treatment evaluation criteria were based on the Putian Drinking Water Test(WST).All patients were evaluated for swallowing function using WST 1 day before treatment;empty using air-pharyngeal movement,using ultrasound to observe tongue movement,laryngeal elevation,distance from hyoid bone to mandible,and pharyngeal wall movement.All patientsunderwent 21-day rehabilitation training,and again used WST to rate The swallowing function of the subjects.Ultrasound was used to observe the relevant swallowing movement indicators,and all the data were measured,recorded,collated and analyzed for statistical processing.Results The first part:(1)There was no significant difference in age,gender,NHISS score and MMSE score between the two groups(P>0.05).(2)Tongue muscle thickness and movement: the thickness of the tongue was significantly higher than that of the control group(46.992±3.868mm).Group(42.354±4.733mm),the difference was statistically significant(P<0.05);the experimental group's tongue movement amplitude,required time,average speed were 1.575(0.120)cm,0.333(0.316)s,5.502 ± 2.170 Cm / s,the control group were 1.622± 0.392 cm,0.191(0.149)s,6.966 ± 2.289 cm / s,the difference was statistically significant(P <0.05);(3)hyoid bone movement: a.The shortening distance and shortening rate between the thyroid cartilage and the thyroid cartilage were 10.865±1.706 mm and 0.398±0.048,which were higher than the experimental group 8.108±1.751 mm and 0.335±0.064.The difference was statistically significant(P<0.05);(2.144 ± 0.347s)was longer than the control group(1.400 ±0.361s),and the difference was statistically significant(P<0.05).b.The shortening distance,shortening rate and time required between the hyoid bone and the mandible of the experimental group were 9.858(3.106)mm,0.237(0.064),2.491±0.467 s,respectively,and the control group was 13.489(2.965)mm,0.329±.0.065,1.623±0.322 s,the difference was statistically significant(P<0.05);(4)pharyngeal sidewall: the experimental group was 1.327 ± 0.216 cm,and the control group was 1.599 ± 0.254 cm.The difference between the two was statistically significant.(P<0.05);the time required for the experimental group was 0.625±0.161 s,and the control group was 0.510±0.128 s.The difference between the two groups was statistically significant(P<0.05).The second part:1.(1)WST evaluated the total proportion of swallowing function I and II before treatment was significantly higher than after treatment;(2)lingual muscle thickness and movement: before and after treatment,the tongue thickness was 46.619 ± 3.634 mm,48.709(5.496)mm The difference was not statistically significant(P=0.153);the difference of tongue movement amplitude,time and speed before and after treatment was statistically significant(P<0.05);(3)hyoid bonemovement: a.hyoid and thyroid cartilage after treatment The change in shortening distance(P=0.003),the change in shortening rate(P=0.009),the change in exercise time(P=0.000),the difference was statistically significant(P<0.05);b.The hyoid to mandible after treatment The shortening distance(P=0.001)and the shortening rate change(P=0.021)were statistically significant;the pre-treatment exercise time(2.350±0.372s)was significantly longer than the post-treatment(1.611±0.305s),and the difference was statistically significant.(P<0.05);(4)pharyngeal wall: the amplitude of motion before and after treatment,the difference was statistically significant(P = 0.000);the pre-treatment exercise time was longer than the treatment,the difference was statistically significant(P = 0.000).2.(1)There was no significant difference in gender,age composition,MMSE and NHISS between the two groups(P>0.05).(2)WST evaluation before and after treatment,swallowing function before and after treatment of patients with true or pseudo-ball paralysis I,The difference of total proportion of grade II was 25.00% and 37.5%,respectively.(3)The amplitude of tongue movement before and after treatment of true and pseudo-ball paralysis was statistically significant(P=0.028).Other parameters of swallowing function were not statistical.Significance(P>0.05).Conclusions:(1)The swallowing function of patients with dysphagia after stroke can be assessed by ultrasound;(2)lingual muscle thickness and movement,hyoid bone movement,pharyngeal wall movement can be used as a good indicator for ultrasound assessment of dysphagia;(3)ultrasound can assess the severity of dysphagia after stroke And the effect of rehabilitation,indicating the practicality of ultrasound evaluation of dysphagia;(4)the amplitude of tongue movement may be a meaningful indicator to distinguish the healing effect of true and pseudo-ball paralysis;tongue thickness,tongue movement speed and time,hyoid bone movement,pharyngeal wall Exercise can not be used as an indicator of ultrasound to distinguish between true and pseudobulbar paralysis. |
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