Non-invasive Measurement Techniques for Swallowing Activity

本研究以自製吞嚥動作檢測儀偵測舌下肌及咽喉的動作，據此推測吞嚥功能並探討食團體積、黏稠度及酸鹼度對吞嚥功能的影響。共有10名健康男性接受本測驗，所有受測者過去都沒有吞嚥障礙的病史，其平均年齡為25±3歲。檢查是以一彈性繃帶為架構，將壓電感測器與加速度計扣於其上，以緊貼受測者之咽喉部，另外，將一壓電感測器以膠帶貼於頷下肌之上，由兩波形間距可算出食團通過舌頭後至咽喉上舉的時間，此定為吞嚥激發時間 (trigger duration)。檢查時，受測者依序吞入1cc，5cc及20cc 25℃的溫水，1/3茶匙布丁，1/8塊蘇打餅乾與5cc的檸檬水。結果顯示，隨著食團體積增加與黏稠度的改變，吞嚥激發時間有明顯的改變，有統計上的差異，而不同酸鹼度的溶液其吞嚥時間亦有明顯的差異。The study aimed to depict the influence of bolus volume, viscosity and taste in swallowing function by a specially-designed phagometer. Both the PVDF sensors and accelerometers were used to detect the submental muscle activity and pharyngeal motion. They were anchored on an elastic bandage to ensure the well contact between the sensor and the skin. The signals detected by PVDF sensors and accelerometers were amplified and recorded simultaneously. The swallowing function was evaluated by using the swallowing trigger duration between the submental muscle activity and the pharyngeal motion. Ten normal male subjects without clinical evidence of dysphagia were enrolled in this study. The average age of the subjects was 25±3 y. The subjects were asked to swallow 1cc, 5cc, 20cc of 250C water, 1/3 teaspoon of pudding, 1/8 piece of soda cracker, and 5cc 250C of lemon water respectively. All subjects had adequate rest between each swallow. The result showed that the trigger duration for swallowing different volume of water reduced as the bolus volume increased with statistical significance. The trigger duration of swallowing different consistency of bolus increase as the viscosity increased. We concluded that the self-designed phagometer can be used to evaluate the swallowing function for various volume bolus and is effective in facilitating the swallowing.誌謝.................................................................................................................................I 中文摘要.......................................................................................................................II 英文摘要......................................................................................................................III 目錄..............................................................................................................................IV 表目錄..........................................................................................................................VI 圖目錄........................................................................................................................VII 第一章 緒論..............................................................................................................1 1-1 前言.........................................................................................................................1 1-2 文獻回顧.................................................................................................................3 1-3 研究動機與目的.....................................................................................................6 1-4 論文架構.................................................................................................................8 第二章 研究原理...................................................................................................11 2-1 正常吞嚥的解剖構造...........................................................................................11 2-2 吞嚥之神經控制機制...........................................................................................12 第三章 研究方法...................................................................................................18 3-1 壓力感測器之設計與原理...................................................................................18 3-1-1 PVDF壓電薄膜之特性..............................................................................19 3-1-2 PVDF壓電sensor製作方法......................................................................22 3-1-3 壓電訊號放大之電路設計與理論...........................................................22 3-1-4 濾波器之設計與理論...............................................................................26 3-2 加速度計之介紹與設計.......................................................................................27 3-2-1 加速度計之介紹.......................................................................................27 3-2-2 加速度計之電路設計...............................................................................28 3-3 影像處理系統之介紹...........................................................................................29 3-3-1 硬體架構設計...........................................................................................29 3-3-2 軟體分析方法...........................................................................................29 3-4 實驗對象...............................................................................................................30 3-5 實驗流程...............................................................................................................30 3-5-1 實驗流程...................................................................................................30 3-5-2 實驗項目...................................................................................................31 3-6資料處理與分析....................................................................................................32 第四章 研究結果與討論.....................................................................................45 4-1體積對吞嚥所造成的影響....................................................................................45 4-2 黏稠度對吞嚥造成的影響...................................................................................48 4-3 酸鹼度對吞嚥造成之影響...................................................................................48 4-4 喉部抬升之研判...................................................................................................49 4-5 實驗討論...............................................................................................................50 第五章 結論與未來展望.....................................................................................62 5-1 結論.......................................................................................................................62 5-2 未來展望...............................................................................................................63 參考文獻......................................................................................................................6