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研究生:邱春燕
研究生(外文):Chun-yen,Chiou
論文名稱:正常與單側唇腭全裂嬰兒在吸吮時顏口部肌肉活動度評估
論文名稱(外文):Evaluation of orofacial muscular activities during sucking in normal and unilateral cleft lip & palate infants
指導教授:蕭裕源蕭裕源引用關係黃炯興黃炯興引用關係
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:口腔生物科學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2001
畢業學年度:89
語文別:中文
論文頁數:104
中文關鍵詞:主題編目分類法
外文關鍵詞:Subject CatalogingClassification
相關次數:
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中文摘要
單側唇腭裂(Unilateral cleft lip and palate;UCLP)嬰兒如何吸吮奶水少見有發表的文章。本研究目的即在了解左、右側唇腭裂嬰兒在接受唇腭修補前、後吸吮時,口部周圍肌肉之肌活動及吸吮頻率(次/秒)。
本研究共有46位一至二十四個月大之正常嬰兒及53位左側唇腭裂和25位右側唇腭裂嬰兒參與本實驗,依年齡分為一、三、六、十二、十八、二十四個月等六組。因唇腭裂嬰兒先於出生後三個月接受唇修補手術,而在十二個月後再接受腭修補手術因此一、二組為未接受唇修補組,三、四組為唇修補組,五、六組為唇腭修補組。實驗方法以壓力偵測器置於奶嘴中以判別吸吮動作。並取20秒連續吸吮動作作為本研究的觀察,同時以表面電極分別置於唇之上、下、左、右四處、舌骨上肌及右側咬肌測20秒連續吸吮動作之肌活動。經以單因子變異數分析所得資料發現,一至二十四個月正常嬰兒的吸吮頻率約為1.31次/秒,各年齡層間皆無顯著差異(p>0.05);左側唇腭裂嬰兒年齡在十二個月時(接受唇修補手術後九個月)吸吮頻率顯著大於年齡二十四個月者(補腭後十二個月) (p<0.05);右側唇腭裂嬰兒年齡六個月(接受唇修補後三個月)的吸吮頻率顯著大於年齡約一個月者(尚未接受唇修補手術前二個月) (p<0.05)。
正常嬰兒的上、下、左、右唇之肌活動度有隨年齡而增加之趨勢,其中左唇及下唇肌活動度於二十四個月明顯大於一個月者(p<0.05) 尤其是下唇肌活動度明顯大於三個月及六個月者(p<0.05) ;左、右唇肌活動度在各年齡無顯著的差異(p>0.05)。
左側唇腭裂嬰兒環口肌活動度有隨年齡增加而增加的趨勢;無論是上、下、左及右唇在二十四個月(補腭後十二個月) 肌活動度顯著大於一個月者(未接受唇腭修補前) (p<0.001),且左及上唇肌活動度於二十四個月明顯大於三個月及六個月者(p<0.05) ;左側唇腭裂嬰兒之左唇肌活動度在各年齡顯著的大於右唇(p<0.05,除十八個月)。
右側唇腭裂嬰兒環口肌活動度會隨年齡增加至十二個月為高峰,爾後有些微遞減;而在十二個月之右唇及下唇肌活動度皆顯著大於一個月者(p<0.05);右側唇腭裂嬰兒之左唇肌活動度在各年齡皆顯著大於右唇(p<0.05,除十二、十八個月)。另外,無論是正常或左及右側唇腭裂嬰兒各年齡的下唇肌活動度皆顯著大於上唇(p<0.05)。
正常嬰兒的舌骨上肌及咬肌肌活動度皆不受年齡的影響。左、右側唇腭裂嬰兒的舌骨上肌及咬肌肌活動與正常嬰兒無明顯的差異,且亦不受年齡及唇腭修補手術的影響(p>0.05)。
左、右側唇腭裂嬰兒在接受唇修補手術前及後三個月下唇肌活動皆小於同年齡之正常嬰兒,但對修補的上唇正常與左、右側唇腭裂嬰兒在接受唇修補手術前及手術後三個月肌活動度無顯著的差異。左、右側唇腭裂嬰兒接受腭修補後六或十二個月下唇肌活動度皆顯著小於同年齡正常嬰兒,左側唇腭裂嬰兒接受腭修補後六個月上唇的肌活動度顯著小於同年齡正常嬰兒(p<0.05)。
依據上述之觀察一至二十四個月正常嬰兒的吸吮頻率不會隨年齡增長而有顯著的改變而正常嬰兒的環口肌活動除咬肌外會隨年齡增加而增大。左、右側唇腭裂嬰兒的吸吮頻率大多不會隨年齡增加而有顯著的改變,而左、右側唇腭裂嬰兒在接受唇修補後九個月(年齡約十二個月)所有環口肌活動度皆大於未接受唇修補的嬰兒;左、右側唇腭裂嬰兒在接受腭修補後十二個月(年齡約二十四個月)環口肌活動度皆大於未接受唇修補的嬰兒或僅接受唇修補的嬰兒。正常嬰兒的左或右及下唇肌活動度在各年齡層中總是大於左、右側唇腭裂嬰兒,尤其是下唇。而在上唇、舌骨上肌及咬肌肌活動度正常組與唇腭裂組在各年齡層中無顯著的差異。本實驗在臨床的意義為針對正常和左、右側唇腭裂嬰兒建立一吸吮時顏口部肌肉活動之相關資料,以用為唇腭裂嬰兒在接受唇腭修補後吸吮功能是否增進之參考。
英文摘要
Purpose : Limited studies related to sucking of the unilateral cleft lip and palate (CLP) infants could be obtained from the previously published articles. The purpose of this study is to understand sucking frequency and the IEMG(Integrated electromyography) muscle activity of the peri-oral muscles for CLP infants before and after surgery.
Methods: Forty-six normal infants, 53 left CLP infants and 25 right CLP infants between the age of one to twenty-four months were recruited in the study as six age groups (1-month, 3-month, 6-month, 12-month, 18-month, 24-month). The first two groups(1-month and 3-month) were the groups before lip-repair, 6-month and 12-month were the groups after lip-repair and the last two groups were the groups with palate-repair.Pressure transducer was placed inside the teat to assess the sucking activity. Sucking frequency was obtained during 20 seconds of continuous sucking. EMG surface electrodes were attached to the suprahyoid muscle, masseter muscles and four muscle groups around the lips to assess the muscle activities during sucking.
Statistics: One-way ANOVA with alpha level of 0.05 was used to analyse the data statistically.
Result: It was found that sucking frequency for normal infants between the age of one and twenty-four months was 1.31 per second and the difference among each group was not significant (p>0.05). For left CLP infants, the sucking frequency in the 12-month group was significantly higher than in the 24-month group (P<0.05). For right CLP infants, the sucking frequency of the 6-month group was significantly higher than that of the 1-month group (P<0.05).The muscle activities for normal infants increased as the age increased. Left and superior peri-oral muscle activities of the 24-month group were significantly higher than that in the 1-month group (P<0.05), especially the inferior peri-oral muscle. There was no significant difference between left and right peri-oral muscle activities among all age groups, however, the inferior peri-oral muscle activities was significantly higher than superior peri-oral muscles (P<0.05). The peri-oral muscle activities of infants in the 24-month group (12 months after palate-repair) were significantly higher than those in the 1-month group (P<0.0001). Both left and superior peri-oral muscle activities of the infants in the 24-month group were significantly higher than the muscle activities of the 3-month group and 6-month groups. The left peri-oral muscle activity of the left CLP infants was significantly higher than that of the right CLP infants (P<0.05, except 18-month group). The muscle activity of the inferior peri-oral muscle was significantly higher than that of the superior peri-oral muscle at all age groups (P<0.05).The muscle activities of right and inferior peri-oral muscles in the 12-month group were significantly higher than the muscle activities in the 1-month group (P<0.05). For each age group, the left peri-oral muscle activity of right CLP infants was significantly higher than right (P<0.05) and the inferior peri-oral muscle activity was significantly higher than the superior peri-oral muscle activity (P<0.05). For normal infants, muscle activities of suprahyoid muscle and masseter were not affected by the age. For left or right CLP infants, the muscle activities of these two muscles were not affected by the age and lip palate repaired surgery (P<0.05) and there was no significant difference compared with normal infants (P>0.05).Inferior peri-oral muscle activity of CLP infants was lower than normal infants before and after three months of lip-repaired surgery. However, there was no significant difference for muscle activity of the superior peri-oral muscle. The inferior peri-oral muscle activity of CLP was significantly lower than it is in normal infants after six or twelve months of palate-repaired surgery. For the superior peri-oral muscle activity, the significant difference was only found in the 18-month group for left CLP infants (P<0.05).
Conclusion: Sucking frequency of normal infants between the age of one to twenty-four months didn’t have significant change as the age increased. However, the muscle activities of peri-oral muscle were significantly higher as the age of infant increased. Sucking frequencies between different age groups for both left and right CLP infants did not have significant changes as the age of infants increased. After surgery at nine months , the peri-oral muscle activities of lip-repaired infants were higher than those CLP unoperated infant. After surgery at twelve months , the peri-oral muscle activities of palate-repaired infants were higher than unoperated and received lip-repaired infants . The left, right and inferior peri-oral muscle activities of normal infants were always higher than those of CLP infants in each age group. The suprahyoid muscle, masseter and superior peri-oral muscles did not have significant difference at all groups.
正常與單側唇腭全裂嬰兒在吸吮時顏口部肌肉活動度評估
Evaluation of orofacial muscular activities during sucking in normal and unilateral cleft lip & palate infants
目錄
表目錄
圖目錄
中文摘要
英文摘要
本文
第一章、 前言
1-1研究背景-------------------------------------------1
1-2研究問題-------------------------------------------4
1-3研究假設-------------------------------------------5
第二章、 文獻回顧
2-1吸吮動作的生理模式---------------------------------6
2-2正常嬰兒吸吮生理功能及動態分析---------------------7
2-3影響吸吮的因素-------------------------------------9
2-4肌電圖應用於口腔周圍肌肉的評估--------------------11
第三章、 實驗方法
  3-1測試對象------------------------------------------16
  3-2測試流程------------------------------------------17
  3-3資料處理------------------------------------------19
  3-4統計分析------------------------------------------21
第四章、 結果
  4-1吸吮頻率的比較------------------------------------22
  4-2吸吮時正常與左、右側唇腭裂嬰兒分別在同一部位不同
年齡層口部肌活動度-------------------------------25
  4-3吸吮時正常與左、右側唇腭裂嬰兒分別在同年齡層不同
部位口部肌活動度---------------------------------28
  4-4吸吮時正常與左、右側唇腭裂嬰兒同一年齡層相同口部
部位肌活動度相互的比較---------------------------29
第五章 討論
5-1 研究限制-----------------------------------------31
5-2 吸吮頻率的討論-----------------------------------32
5-3吸吮時正常與左、右側唇腭裂嬰兒分別在同一部位不同
年齡層口部肌活動度的討論-------------------------34
5-4吸吮時正常與左、右側唇腭裂嬰兒分別在同年齡層不同
部位口部肌活動度的討論---------------------------36
5-5吸吮時正常與左、右側唇腭裂嬰兒同一年齡層不同口部
部位肌活動度相互的討論---------------------------38
5-6未來研究的方向------------------------------------41
第六章 結論----------------------------------------------42
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