中国 非线性视频编辑软件 EDIUS PRO 9

摘要 · 中文整理：目的：探讨吞咽指导的方法与内容对帕金森病（PD）患者指导依从性的影响。方法：在 317 例接受吞咽造影检查（VF）的 PD 患者中，共分析了 59 例在 VF 前后 45 天内完成日文版吞咽障碍障碍指数（DHI-J）的患者。根据自指导起至 6 个月期间对代偿策略依从情况的记录，将患者分为依从组（CP）与不依从组（NCP）。结果：NCP 组与 CP 组分别为 31 例（52.5%）与 28 例（47.5%）。自评严重程度与 DHI 评分无显著差异，生活质量（QOL）与疾病认知并不影响依从性。CP 组中采用吞咽图表或书面材料接受指导的患者多于 NCP 组，且与家人同住者更多。NCP 组指导后复评（Post）较指导前复评（Pre）DHI 身体维度（P）与 DHI 总分显著升高、QOL 显著降低；相反，CP 组 Post 较 Pre 的 DHI-P、DHI 情绪维度与 DHI 总分显著降低、QOL 显著升高。结论：在针对吞咽障碍进行代偿策略指导时，采用视觉化材料而非仅靠口头讲解，有利于提高对指导内容的依从性；对吞咽指导的依从可在干预后维持并改善生活质量。与家人同住的患者依从性更好，可能与家人备餐及其建议与配合有关。

原文摘要：Objectives: To investigate the effects of swallowing instructional methods and content on instructional compliance among patients with Parkinson's disease (PD). Methods: Overall, 59 of the 317 patients with PD who underwent a videofluoroscopic examination of swallowing (VF) and completed the Japanese version of the Dysphagia Handicap Index (DHI-J) within 45 days before and after VF were analyzed. Based on records of compliance with alternative strategies from the time of instruction to 6 months, patients were classified into the compliance (CP) and noncompliance (NCP) groups. Results: The NCP and CP groups included 31 (52.5%) and 28 (47.5%) patients, respectively. No significant differences in self-reported severity or DHI score were identified, and quality of life (QOL) and awareness did not influence compliance. The CP group had more patients who received instruction using swallowing charts or handouts than the NCP group. More patients lived with family members. The NCP group had significantly higher DHI-Physical (P) and DHI-Total scores and lower QOL post-instruction reassessment (Post) than pre-instruction reassessment (Pre). Conversely, the CP group had significantly lower DHI-P, DHI-Emotional, and DHI-Total scores and higher QOL in Post than in Pre. Conclusions: When teaching swallowing with alternative strategies for dysphagia, using visual elements rather than verbal instructional elements alone is beneficial for improving compliance with instructional content. Compliance with swallowing instructions can maintain and improve QOL after the intervention. Patients living with family members demonstrated better compliance, likely due to meals provided by family members, along with advice and cooperation influencing compliance with the guidelines.

关键词：吞咽障碍、指导方法、帕金森病、生活质量、吞咽指导

研究目标：明确哪些吞咽指导方法和内容能够提高帕金森病吞咽障碍患者对替代吞咽策略的依从性，以及依从性与患者生活质量之间的关系。

主要结论：采用图表或讲义等视觉元素进行吞咽指导比单纯口头指导更能提高依从性；遵守指导的患者干预后DHI评分下降、生活质量得以维持或改善；与家人同住者依从性更高。

创新点：首次以回顾性方式将吞咽造影后指导方式（口头、图表、讲义）与6个月依从性和DHI-J生活质量变化联系起来，并揭示家庭支持对依从性的作用。

后续建议：开展前瞻性随机对照研究验证不同指导方式的效果；引入客观依从性监测手段替代患者自述；结合VF定量参数（如咽部残留量化）细化指导内容；延长随访时间以评估长期QOL变化；探讨照护者教育对依从性的独立贡献

APA 引文：Nakayama, K., Yamamoto, T., Hara, T., Takahashi, Y., Murakami, T., Sano, H., & Nishida, D. (2025). Compliance with swallowing instruction and quality of life in patients with Parkinson's disease: A retrospective assessment of instructional methods to maintain and improve quality of life. World Journal of Otorhinolaryngology - Head and Neck Surgery, 12(2), 177–188. https://doi.org/10.1002/wjo2.70039

仪器引用：Fluoroscopy was performed from the oral cavity to the upper esophagus, and swallowing movements were recorded at 30 frames per second on an external hard disk to assess the VF findings. Image analysis was conducted using EDIUS Pro 9® (Grass Valley, Montreal, Canada).