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超声评估吞咽运动的应用现状
吞咽是指将摄入的食物咀嚼形成食团,经口腔运送至胃的过程,通常包含口期、咽期和食管期。其中任何一个环节或阶段出现异常均可能导致吞咽障碍。吞咽障碍在急性脑血管疾病患者中的发病率可达30%~78%[1-2],其可影响机体康复,并引起脱水、营养缺乏、吸入性肺炎,甚至导致死亡。因而在临床治疗过程中,对吞咽障碍的准确评估非常重要。对吞咽困难的评定手段有很多种,包括:电视透视吞咽功能检查(videofluoroscopic swallowing study, VFSS)、纤维内镜吞咽功能评估(fiberopticendoscopic examination of swallowing,FEES)、电磁关节造影术(electro-magnetic articulography)、表面肌电图检查(electromyography)、磁共振成像(magnetic resonance imaging)、腭动测量法(palatography)、舌压测定(tongue pressure measurement)、闪烁扫描法(scintigraphy)及各种测量量表。其中,电视透视吞咽功能检查被公认为诊断吞咽障碍的金标准[3-5],但该方法对病情较重或有认知障碍的患者存在一定的危险性,且该方法对患者有一定的辐射损伤,难以在短时间内进行重复操作。
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A Three -Dimensional Finite Element Model of the Foot and Ankle for Foot Support Design
Understanding of the biomechanics of human foot and ankle complex can help in designing a better foot support. Experimental approaches are limited to interfacial pressure measurement between the foot and supporting surface and gross motion tracking of major foot joints. The measurement of internal stress/strain and individual bony movement of the foot and ankle,which is essential in enhancing knowledge on the biomechanics of the foot, is still sparse due to experimental difficulties. Computer simulation provides an efficient alternative to acquire those important clinical parameters.