%0 Journal Article %T 超声波检查在脑性瘫痪儿童口咽期吞咽障碍评估中的应用<br>Submental ultrasonongraphy in assessing oropharyngeal swallowing disorders in children with cerebral palsy %A 熊华春 %A 黄姣姣 %A 肖宁 %A 朱登纳 %A 高志萍 %A 赵云霞 %A 王军 %J 中华物理医学与康复杂志 %D 2017 %X 目的 探讨颏下超声（SUS）检查在脑性瘫痪（简称脑瘫）儿童口咽期吞咽障碍评估中的应用价值。 方法 选取17例口咽期吞咽障碍脑瘫儿童（7例依赖鼻饲进食，10例常规经口进食）和20例吞咽功能正常儿童分别纳入观察组和正常对照组。应用SUS测量受试者吞咽5ml水时舌肌厚度变化及舌骨位移幅度，将测量结果与功能性经口摄食量表（FOIS）评估结果进行比较，初步确定应用SUS检查判断是否依赖鼻饲的界值；通过分析不同评估者应用SUS测量受试者舌肌厚度变化及舌骨位移数据，计算20例吞咽功能正常儿童的组内相关系数（ICC），进而确定SUS检查方法的评估者间及评估者内信度。 结果 通过观察所有受试者舌肌厚度变化及舌骨位移幅度，发现鼻饲依赖组患儿上述两种指标变化幅度均明显小于非鼻饲依赖组和正常对照组（P<0.05），初步确定舌肌厚度变化界值为1.0cm，舌骨位移幅度界值为1.5cm；计算ICC值均大于0.4，提示SUS检查具有较好的评估者间/评估者内信度。 结论 SUS检查能够辅助评估口咽期吞咽障碍脑瘫患儿的吞咽功能。<br>Objective To explore the application of submental ultrasonongraphy (SUS) in the assessment of oropharyngeal swallowing disorders in children with cerebral palsy. Methods Seventeen children with cerebral palsy and oropharyngeal swallowing difficulties (7 on nasal feeding, 10 on oral feeding) constituted the treatment group while 20 normal counterparts formed the control group. SUS was applied to measure any changes in the thickness of the tongue muscle and the range of hyoid bone displacement when they swallowed 5 ml of water. The results were compared with those assessed using the functional oral intake scale to decide the best cut-off point for detecting tube-feeding-dependent dysphagia. The intraclass correlation coefficient (ICC) of the 20 children in the control group was calculated to evaluate the intra-rater and inter-rater reliability of SUS. Results The average tongue muscle thickness change and hyoid bone displacement amplitude of the children on nasal feeding were significantly smaller than those of the children without nasal feeding and the normal children. The best cut-off point for the tongue muscle thickness change data was 1.0 cm, and that of the hyoid bone displacement amplitude was 1.5 cm. All of the ICCs were above 0.4, indicating good intra-rater and inter-rater reliability for the SUS examination. Conclusion Submental ultrasonongraphy can help assess the swallowing function of children with oropharyngeal swallowing disorders %K 脑性瘫痪 吞咽障碍评估 颏下超声< %K br> %K Cerebral palsy Assessment Dysphagia Submental ultrasonography Ultrasound %U http://www.cjpmr.cn/ch/reader/view_abstract.aspx?file_no=熊华春201706&flag=1