鼻咽癌放疗后患者吞咽时颏下肌群和舌骨下肌群表面肌电信号特征分析

目的 研究鼻咽癌（NPC）放疗后患者吞咽时颏下肌群和舌骨下肌群的表面肌电信号特征。 方法 选取经吞咽造影检查证实存在咽期吞咽障碍的NPC放疗后患者15例，设为患者组，另选取健康受试者15例设为健康组，采用表面肌电图（sEMG）进行检测，分别记录受试者干吞咽和吞咽3ml浓流质时颏下肌群和舌骨下肌群的sEMG信号，对2组受试者的肌电活动持续时间、平均振幅和峰值进行比较。 结果 患者组在干吞咽和吞咽3ml浓流质时颏下肌群和舌骨下肌群的sEMG持续时间［干吞咽时颏下肌群和舌骨下肌群的sEMG持续时间分别为（1.94±0.60）s（3.43±0.94）s；吞咽3ml浓流质时颏下肌群和舌骨下肌群的sEMG持续时间分别为（1.96±0.61）s和（3.45±0.92）s］较健康组均显著延长，组间差异均有统计学意义（P<0.05），且患者组吞咽3ml浓流质时颏下肌群和舌骨下肌群的sEMG持续时间显著长于干吞咽时，差异均有统计学意义（P<0.05）。患者组在干吞咽和吞咽3ml浓流质时颏下肌群和舌骨下肌群的sEMG峰值和平均振幅均显著高于健康组，组间差异均有统计学意义（P<0.05），且患者组吞咽3ml浓流质时颏下肌群和舌骨下肌群的sEMG峰值和平均振幅亦显著高于干吞咽时，差异均有统计学意义（P<0.05）。 结论 NPC放疗后患者吞咽时颏下肌群和舌肌下肌群表现为强化收缩，可在吞咽过程中发挥代偿作用。

The characteristics of the surface electromyographic signals recorded from submental and infrahyoid muscles when swallowing in patients with nasopharyngeal carcinoma after radiotherapy

Objective To study the surface electromyographic signal characteristics of submental and infrahyoid muscles when swallowing in patients with nasopharyngeal carcinoma (NPC) following radiotherapy. Methods Fifteen post-radiotherapy NPC patients with pharyngeal dysphagia confirmed by videofluoroscopie swallowing study (VFSS) were selected into the patient group, while another 15 healthy subjects were recruited into the healthy group. Surface electomyography (sEMG) was used to collect sEMG signals from submental muscles and infrahyoid muscles during both dry and 3 ml thick liquid swallowing, and sEMG duration, average amplitude and peak amplitude para-meters were compared between the two groups. Results Compared with healthy subjects, the patient group showed significantly longer sEMG duration of submental muscles and infrahyoid muscles during dry swallowing and 3 ml thick liquid swallowing (P<0.05). Moreover, significantly longer sEMG duration of submental muscles and infrahyoid muscles was observed when swallowing 3 ml thick liquid, compared with dry swallowing (P<0.05). The average sEMG amplitude and peak amplitude of submental muscles and infrahyoid muscles of patients when dry swallowing and 3 ml thick liquid swallowing were both significantly higher than those of healthy subjects (P<0.05). Conclusion Submental muscles and infrahyoid muscles manifested enhanced contractions during swallowing in NPC patients with dysphagia, which played a compensatory role after radiotherapy.