超声参数用于卒中后吞咽困难的评估与康复监测：一项叙述性综述

文献信息

中文摘要

背景： 卒中后吞咽困难是卒中的常见并发症。定量超声检查已成为一种无创、无辐射且可重复的方法，用于评估吞咽相关结构和运动。本叙述性综述总结了用于卒中患者吞咽评估和康复监测的定量超声参数。方法：超声衍生测量按肌肉数量与形态、肌肉质量、空间/运动学功能以及时间/速度功能进行分类。结果：研究已证实吞咽相关肌肉形态的改变；舌、舌骨上肌群、舌骨和舌喉结构的运动减少；以及运动持续时间和速度的变化。若干动态指标与吞咽困难严重程度及常规吞咽评估相关。超声检查也被纵向用于监测不同治疗干预下康复相关的肌肉形态和吞咽运动学变化。然而，吞咽功能的改善并不总是伴随单个超声参数的改变。结论：动态超声参数有潜力表征吞咽损害并监测康复相关变化，而定量超声检查可能为重复床旁评估提供补充方法。需要进一步研究采用标准化采集方案、明确定义的参数，并针对已建立的吞咽评估进行验证，以支持更广泛的临床应用。

英文摘要

Post-stroke dysphagia is a common complication of stroke. Quantitative ultrasonography has emerged as a noninvasive, radiation-free, and repeatable approach for evaluating swallowing-related structures and movements. This narrative review summarizes quantitative ultrasound parameters used for swallowing assessment and rehabilitation monitoring in patients with stroke. Ultrasound-derived measurements were categorized according to muscle quantity and morphology, muscle quality, spatial/kinematic function, and temporal/velocity function. Studies have demonstrated alterations in swallowing-related muscle morphology; reductions in the movement of the tongue, suprahyoid musculature, hyoid bone, and hyolaryngeal structures; and changes in movement duration and velocity. Several dynamic measures have been associated with the severity of dysphagia and conventional swallowing assessments. Ultrasonography has also been used longitudinally to monitor rehabilitation-related changes in muscle morphology and swallowing kinematics across different therapeutic interventions. However, improvements in swallowing function were not consistently accompanied by changes in individual ultrasound parameters. Dynamic ultrasound parameters have the potential to characterize swallowing impairment and monitor rehabilitation-related changes, whereas quantitative ultrasonography may provide a complementary approach to repeated bedside assessments. Further studies using standardized acquisition protocols, clearly defined parameters, and validation against established swallowing assessments are required to support broader clinical applications.