新型液体口香糖增稠剂对独立生活的老年口咽部吞咽困难患者吞咽功能和水合状态的治疗效果,Nutrients

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新型液体口香糖增稠剂对独立生活的老年口咽部吞咽困难患者吞咽功能和水合状态的治疗效果
Nutrients ( IF 4.546 ) Pub Date : 2023-10-31 , DOI: 10.3390/nu15214621
Noemí Tomsen _{1,

2} , Mireia Bolívar-Prados _{1,

2} , Omar Ortega _{1,

2} , Pere Clavé _{1,

2}

Affiliation

ThickenUp® Gel Express (TUGE) 是一种基于黄原胶和阿拉伯胶的新型液体增稠产品。在患有口咽吞咽困难 (OD) 的独立生活老年人中，我们评估了：(1) TUGE 的流变特性；(2) 四种粘度水平下的治疗效果（通过 5 g、10 g、20 g 和 30 g TUGE 水溶液 + Omnipaque X 射线对比实现）与稀液体的治疗效果；(3)十四天后对水合状态和胃肠道耐受性的影响。TUGE 的剪切粘度以 SI 单位测量（mPa·s，50 s−1）。通过视频荧光镜检查 (VFS) 评估渗透吸入量表 (PAS) 评分和每个粘度水平的吞咽反应，在为期 14 天的研究中，我们评估了液体摄入量、水合作用和耐受性。使用 TUGE 增稠的液体不受 α-唾液淀粉酶 (α-SA) 的影响 (-0.3%)。VFS 的剪切粘度值为 49.41 ± 2.38、154.83 ± 10.22、439.33 ± 11.72 和 672.5 ± 35.62 mPa·s。我们研究了 60 名具有轻度 OD（PAS 4.1 ± 2.2，25% 愿望）的独立生活成年人（70 ± 11.4 岁）。TUGE 在 150–670 mPa·s 下引起 PAS 的剪切粘度依赖性改善，并保证吞咽安全，口腔残留物略有增加，不影响咽部残留物，并在 670 mPa·s 下缩短喉前庭闭合时间 (-27%) s。TUGE 的液体摄入量（1488 mL/天）耐受性良好，水合状态得到改善。总之，TUGE 不受 α-SA 的影响，并且以粘度依赖性方式极大地提高了吞咽安全性，且不影响咽部残留物。使用 TUGE 对稠化液体进行为期 14 天的治疗是安全且耐受性良好的，并且可以改善患有吞咽困难的老年人的水合状态。

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Therapeutic Effect on Swallowing Function and on Hydration Status of a New Liquid Gum-Based Thickener in Independently-Living Older Patients with Oropharyngeal Dysphagia

ThickenUp® Gel Express (TUGE) is a new, xanthan- and acacia-gum-based, liquid, thickening product. In independently living older adults with oropharyngeal dysphagia (OD), we assessed: (1) the rheological properties of TUGE; (2) its therapeutic effect at four viscosity levels (achieved by 5 g, 10 g, 20 g and 30 g of TUGE in water + Omnipaque X-ray contrast) versus thin liquid; and (3) the effect on hydration status and gastrointestinal tolerance after fourteen days. Shear viscosity of TUGE was measured in SI units (mPa·s at 50 s−1). The Penetration Aspiration Scale (PAS) score and the swallow response at each viscosity level was assessed with videofluoroscopy (VFS), and in the 14-day study we assessed fluid intake, hydration, and tolerance. Thickened fluids with TUGE were unaffected (−0.3%) by α-salivary amylase (α-SA). The shear viscosity values with VFS were 49.41 ± 2.38, 154.83 ± 10.22, 439.33 ± 11.72 and 672.5 ± 35.62 mPa·s. We studied 60 independently living adults (70 ± 11.4 years) with mild OD (PAS 4.1 ± 2.2, 25% aspirations). TUGE caused a shear-viscosity-dependent improvement in PAS at 150–670 mPa·s and in safety of swallow, slightly increased oral residue, did not affect pharyngeal residue and reduced time to laryngeal vestibule closure (−27%) at 670 mPa·s. Fluid intake with TUGE (1488 mL/day) was well tolerated, and hydration status improved. In conclusion, TUGE was unaffected by α-SA and strongly improved safety of swallow in a viscosity-dependent manner without affecting pharyngeal residue. Fourteen-day treatment of thickened fluids with TUGE is safe and well tolerated and improves hydration status in older adults with dysphagia.

更新日期：2023-11-01

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