综述

呼吸与吞咽间的交互关系及其应用

  • 刘邦亮 ,
  • 朱美兰 ,
  • 刘惠宇 ,
  • 张蕊 ,
  • 张娟娟 ,
  • 江迎
展开
  • 1.南昌大学第二附属医院康复医学科,江西南昌市 330006;
    2.南昌大学江西医学院,江西南昌市 330006;
    3.粤北人民医院康复医学科,广东韶关市512025;
    4.南方医科大学第三附属医院,广东广州市 510000
刘邦亮(1991-),男,汉族,江西赣州市人,硕士研究生,医师,主要研究方向:神经系统疾病及腰腿疼痛等的康复。

收稿日期: 2018-04-12

  网络出版日期: 2018-10-30

Interaction between Respiration and Swallowing and Its Application (review)

  • LIU Bang-liang ,
  • ZHU Mei-lan ,
  • LIU Hui-yu ,
  • ZHANG Rui ,
  • ZHANG Juan-juan ,
  • JIANG Ying
Expand
  • 1. Rehabilitation Medicine Division, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China;
    2. Nanchang University Jiangxi Medical College, Nanchang, Jiangxi 330006, China;
    3. Rehabilitation Medicine Division, Yue Bei People's Hospital, Shaoguan, Guangdong 512025, China;
    4. the Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510000, China

Received date: 2018-04-12

  Online published: 2018-10-30

摘要

吞咽障碍发生后易并发呼吸与吞咽间的不协调,致使误吸、呛咳、吸入性肺炎的发生。本文综述呼吸与吞咽间的具体生理机制及其临床运用,旨在关注呼吸、吞咽系统在健康及疾病之间的关系,探其在吞咽障碍临床治疗中的指导价值。

本文引用格式

刘邦亮 , 朱美兰 , 刘惠宇 , 张蕊 , 张娟娟 , 江迎 . 呼吸与吞咽间的交互关系及其应用[J]. 中国康复理论与实践, 2018 , 24(10) : 1165 -1168 . DOI: 10.3969/j.issn.1006-9771.2018.10.009

Abstract

Dysphagia is often associated with incoordination between breathing and swallowing, resulting in the occurrence of aspiration, cough and aspiration pneumonia. This article reviewed the specific physiological mechanisms of respiration and swallowing and their clinical applications, which aimed to focus on the relationship between respiration and swallowing systems in health and disease, and to explore its guiding value in the clinical treatment of dysphagia.

参考文献

[1] Momosaki R, Abo M, Watanabe S, et al. Repetitive Peripheral magnetic stimulation with intensive swallowing rehabilitation for poststroke dysphagia: an open-label case series [J]. Neuromodulation, 2015, 18(7): 630-634, discussion: 634-635.
[2] 窦祖林. 吞咽障碍评估与治疗[M]. 2版. 北京:人民卫生出版社, 2017: 666.
[3] 励建安,黄晓琳. 康复医学[M]. 北京:人民卫生出版社, 2016: 607.
[4] Wong SM, Domangue RJ, Fels S, et al.Evidence that an internal schema adapts swallowing to upper airway requirements[J]. J Physiol, 2017, 595(5): 1793-1814.
[5] Martin-Harris B, Brodsky MB, Price CC, et al.Temporal coordination of pharyngeal and laryngeal dynamics with breathing during swallowing: single liquid swallows[J]. J Appl Physiol (1985), 2003, 94(5): 1735-1743.
[6] Martin-Harris B.Clinical implications of respiratory-swallowing interactions[J]. Curr Opin Otolaryngol Head Neck Surg, 2008, 16(3): 194-199.
[7] Hiss SG, Strauss M, Treole K, et al.Effects of age, gender, bolus volume, bolus viscosity, and gustation on swallowing apnea onset relative to lingual bolus propulsion onset in normal adults[J]. J Speech Lang Hear Res, 2004, 47(3): 572-583.
[8] Bolser DC, Pitts TE, Davenport PW, et al.Role of the dorsal medulla in the neurogenesis of airway protection[J]. Pulm Pharmacol Ther, 2015, 35: 105-110.
[9] 汪洁. 吞咽的生理机制与卒中后吞咽障碍[J]. 中国卒中杂志, 2007, 2(3): 220-225.
[10] 汪进丁,徐丽君. 脑卒中吞咽障碍的病理生理机制研究进展[J]. 中国康复医学杂志, 2008, 23(7): 666-668.
[11] Martin-Harris B, Mcfarland D, Hill EG, et al.Respiratory-swallow training in patients with head and neck cancer[J]. Arch Phys Med Rehabil, 2015, 96(5): 885-893.
[12] Butler SG, Stuart A, Pressman H, et al.Preliminary investigation of swallowing apnea duration and swallow/respiratory phase relationships in individuals with cerebral vascular accident[J]. Dysphagia, 2007, 22(3): 215-224.
[13] Ghannouchi I, Speyer R, Doma K, et al.Swallowing function and chronic respiratory diseases: Systematic review[J]. Respir Med, 2016, 117: 54-64.
[14] Park BH, Seo JH, Ko MH, et al.Effect of 45 degrees reclining sitting posture on swallowing in patients with dysphagia[J]. Yonsei Med J, 2013, 54(5): 1137-1142.
[15] Ayuse T, Ayuse T, Ishitobi S, et al.Effect of reclining and chin-tuck position on the coordination between respiration and swallowing[J]. J Oral Rehabil, 2006, 33(6): 402-408.
[16] Pitts T, Morris K, Lindsey B, et al.Co-ordination of cough and swallow in vivo and in silico[J]. Exp Physiol, 2012, 97(4): 469-473.
[17] Terzi N, Orlikowski D, Aegerter P, et al.Breathing-swallowing interaction in neuromuscular patients: a physiological evaluation[J]. Am J Respir Crit Care Med, 2007, 175(3): 269-276.
[18] Kelly BN, Huckabee ML, Jones RD, et al.The first year of human life: coordinating respiration and nutritive swallowing[J]. Dysphagia, 2007, 22(1): 37-43.
[19] Roth EJ, Noll SF.Stroke rehabilitation. 2. Comorbidities and complications[J]. Arch Phys Med Rehabil, 1994, 75(5 Spec No): S42-S46.
[20] Jung JH, Shim JM, Kwon HY, et al.Effects of abdominal stimulation during inspiratory muscle training on respiratory function of chronic stroke patients[J]. J Phys Ther Sci, 2014, 26(1): 73-76.
[21] Lanini B, Bianchi R, Romagnoli I, et al.Chest wall kinematics in patients with hemiplegia[J]. Am J Respir Crit Care Med, 2003, 168(1): 109-113.
[22] Khedr EM, El SO, Khedr T, et al.Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients[J]. Eur J Neurol, 2000, 7(5): 509-516.
[23] Messaggi-Sartor M, Guillen-Sola A, Depolo M, et al.Inspiratory and expiratory muscle training in subacute stroke: A randomized clinical trial[J]. Neurology, 2015, 85(7): 564-572.
[24] Moon JH, Jung JH, Won YS, et al.Effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia[J]. J Phys Ther Sci, 2017, 29(4): 609-612.
[25] Troche MS, Rosenbek JC, Okun MS, et al.Detraining outcomes with expiratory muscle strength training in Parkinson disease[J]. J Rehabil Res Dev, 2014, 51(2): 305-310.
[26] 米海英. 老年患者卒中后呼吸肌训练对卒中后呼吸系统并发症的影响[J]. 双足与保健, 2017, 26(4): 25-26.
[27] 路惠,冯为菊,丁荧,等. 头颈部控制及呼吸肌训练在早期脑卒中吞咽障碍患者中的康复疗效观察[J]. 实用临床医药杂志, 2015, 19(23): 111-112.
[28] Moon JH, Jung JH, Won YS, et al.Effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia[J]. J Phys Ther Sci, 2017, 29(4): 609-612.
[29] Laciuga H, Rosenbek JC, Davenport PW, et al.Functional outcomes associated with expiratory muscle strength training: narrative review[J]. J Rehabil Res Dev, 2014, 51(4): 535-546.
[30] Pitts T, Bolser D, Rosenbek J, et al.Impact of expiratory muscle strength training on voluntary cough and swallow function in Parkinson disease[J]. Chest, 2009, 135(5): 1301-1308.
[31] Mcfarland DH, Lund JP, Gagner M.Effects of posture on the coordination of respiration and swallowing[J]. J Neurophysiol, 1994, 72(5): 2431-2437.
[32] Ayuse T, Ayuse T, Ishitobi S, et al.Effect of reclining and chin-tuck position on the coordination between respiration and swallowing[J]. J Oral Rehabil, 2006, 33(6): 402-408.
[33] Hardemark CA, Boden K, Witt HH, et al.Breathing and swallowing in normal man;#x02013;effects of changes in body position, bolus types, and respiratory drive[J]. Neurogastroenterol Motil, 2010, 22(11): 1201-1208, e316.
[34] Logemann JA.Rehabilitation of oropharyngeal swallowing disorders[J]. Acta Otorhinolaryngol Belg, 1994, 48(2): 207-215.
[35] Nagy A, Molfenter SM, Peladeau-Pigeon M, et al.The effect of bolus consistency on hyoid velocity in healthy swallowing[J]. Dysphagia, 2015, 30(4): 445-451.
[36] Nagy A, Molfenter SM, Peladeau-Pigeon M, et al.The effect of bolus volume on hyoid kinematics in healthy swallowing[J]. Biomed Res Int, 2014, 2014: 738971.
[37] Jang HJ, Leigh JH, Seo HG, et al.Effortful swallow enhances vertical hyolaryngeal movement and prolongs duration after maximal excursion[J]. J Oral Rehabil, 2015, 42(10): 765-773.
[38] Seo HG, Oh BM, Leigh JH, et al.Correlation varies with different time lags between the motions of the hyoid bone, epiglottis, and larynx during swallowing[J]. Dysphagia, 2014, 29(5): 591-602.
[39] Newman R, Vilardell N, Clave P, et al.Effect of bolus viscosity on the safety and efficacy of swallowing and the kinematics of the swallow response in patients with oropharyngeal dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD)[J]. Dysphagia, 2016, 31(2): 232-249.
[40] Martin-Harris B, Brodsky MB, Michel Y, et al.Breathing and swallowing dynamics across the adult lifespan[J]. Arch Otolaryngol Head Neck Surg, 2005, 131(9): 762-770.
[41] Dozier TS, Brodsky MB, Michel Y, et al.Coordination of swallowing and respiration in normal sequential cup swallows[J]. Laryngoscope, 2006, 116(8): 1489-1493.
[42] Matsuo K, Hiiemae KM, Gonzalez-Fernandez M, et al.Respiration during feeding on solid food: alterations in breathing during mastication, pharyngeal bolus aggregation, and swallowing[J]. J Appl Physiol (1985), 2008, 104(3): 674-681.
文章导航

/