本文選題：帕金森病 + 吞咽障礙��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:通過改良的吞鋇造影評估體系(Modified Barium Swallow Impairment Profile,MBSIm P)及Rosenbek穿透-誤吸量表從吞咽有效性和安全性兩方面量化評估帕金森患者口咽吞咽過程,并對其進行相關性分析。方法:1.在線學習改良的吞鋇造影評估體系(Modified Barium Swallow Impairment Profile,MBSIm P),并通過MBSIm P官方在線考核,取得可在臨床使用該評估體系的資質。2.臨床資料搜集及吞咽檢查:篩選2015年12月-2016年12月山西醫(yī)科大學第一醫(yī)院神經內科診斷的符合納入排除標準的帕金森患者并搜集患者病情相關資料,在患者及家屬知情同意的情況下完成造影檢查。3.運用MBSIm P、Rosenbek穿透-誤吸量表從吞咽有效性和安全性兩方面量化評估患者口咽吞咽過程。4.數(shù)據分析:根據數(shù)據類型及分布特征對變量進行統(tǒng)計描述;根據吞咽安全性評估結果,將帕金森患者分為穿透誤吸陽性和陰性組,采用Mann-Whitney秩和檢驗比較兩組患者的差異;采用Cochran’s Q檢驗比較不同食物性狀及進食方式對吞咽安全的影響;等級資料運用Spearman秩相關進行相關性研究;檢驗水準α=0.05,p≤0.05有統(tǒng)計學意義。結果:1.本研究共有40名帕金森患者符合納入排除標準,其中男性患者21名(52.5%),女性患者19名(47.5%),40名患者(100%)均有不同程度的吞咽障礙,且主要為輕中度水平,癥狀可同時累及口咽期。2.40名研究對象中有20名(50%)患者存在穿透誤吸癥狀,其中7名(17.5%)患者為誤吸,13名(32.5%)患者為穿透;18名(45%)患者為隱性癥狀,2名(5%)患者為隱性、顯性共存;HoehnYahr分級越高,穿透誤吸患病率越高。3.穿透誤吸陽性組和陰性組在HoehnYahr分級、UPDRS總分、UPDRSⅢ得分、病程、咽期吞咽癥狀均存在顯著差異。4.穿透誤吸陽性組進食5ml不同稠度的食物時,吞咽安全并無差異,但連續(xù)吞咽時,穿透誤吸風險顯著增高。5.40名患者的UPDRS總分、UPDRSⅢ得分與口腔期、咽期總分、穿透誤吸得分顯著相關,HoehnYahr分級只與口腔期總分、穿透誤吸得分相關,病程與咽期總分、穿透誤吸得分相關。結論:1.帕金森患者口咽吞咽障礙可同時累及口咽期且主要為輕中度水平。2.帕金森患者的穿透誤吸主要為隱性癥狀,提示帕金森患者存在咽喉感覺減退現(xiàn)象。3.少量進食時,食物性狀對吞咽安全影響較小;但連續(xù)吞咽會顯著增加穿透誤吸風險。4.從臨床表現(xiàn)方面評估,帕金森患者口咽吞咽障礙與帕金森病情呈正相關;但從臨床殘疾角度分析,HoehnYahr分級與帕金森病口咽吞咽障礙的相關性有待進一步明確。
[Abstract]:Objective: to evaluate the oral swallowing process of Parkinson's patients quantitatively by modified Barium Swallow Impairment Profilesis-MBSIm PIm (modified barium swallowing) and Rosenbek Penetration and misprision scale (Rosenbek) in terms of effectiveness and safety of swallowing, and to analyze the correlation between them. Method 1: 1. The modified barium swallowing imaging evaluation system was improved by online learning. The qualification of modified Barium Swallow Impairment Profilesis-MBSIm Pe was obtained by MBSIm P official online examination, and the qualification of the evaluation system was obtained. 2. Clinical data collection and swallowing examination: screening PD patients diagnosed by Department of Neurology, first Hospital of Shanxi Medical University from December 2015 to December 2016, and collecting relevant data of patients' condition, Complete the examination with the informed consent of the patient and his / her family. The oral swallowing process of patients was evaluated quantitatively by using the MBSIm P Rosenbek Penetration and misprision scale in terms of both the efficacy and safety of swallowing. Data analysis: the variables were statistically described according to the data types and distribution characteristics, and according to the results of swallowing safety evaluation, Parkinson's patients were divided into positive and negative groups of penetrating aspiration. The difference between the two groups was compared by Mann-Whitney rank sum test. Cochran's Q test was used to compare the effects of different food traits and eating patterns on swallowing safety; Spearman rank correlation was used to study the correlation of grade data; the test level 偽 -0. 05 p 鈮，

本文編號：1818267