Huckabee M L, Cannito M P
School of Audiology and Speech Language Pathology, The University of Memphis, Memphis, Tennessee, USA.
Dysphagia. 1999 Spring;14(2):93-109. doi: 10.1007/PL00009593.
This study examines the functional and physiologic outcomes of treatment in a group of 10 patients with chronic dysphagia subsequent to a single brainstem injury. All patients participated in a structured swallowing treatment program at a metropolitan teaching hospital. This program differs from more traditional swallowing treatment by the inclusion of surface electromyography biofeedback as a treatment modality and the completion of 10 hr of direct treatment in the first week of intervention. A retrospective analysis of medical records and patient questionnaires was used to gain information regarding medical history, site of lesion, prior interventions, and patient perception of swallowing recovery. Physiologic change in swallowing treatment, as measured by severity ratings of videofluoroscopic swallowing studies, was demonstrated in nine of 10 patients after 1 week or 10 sessions of treatment. Functional change was measured by diet level tolerance after 1 week of treatment, at 6 months, and again at 1 year posttreatment. Eight of the 10 patients were able to return to full oral intake with termination of gastrostomy tube feedings, whereas two demonstrated no long-term change in functional swallowing. Of the eight who returned to full oral intake, the average duration of tube feedings following treatment until discontinuation was 5.3 months, with a range of 1-12 months. Six patients who returned to oral intake maintained gains in swallowing function, and two patients returned to nonoral nutrition as the result of a new unrelated medical condition.
本研究调查了一组10例因单一脑干损伤导致慢性吞咽困难患者的治疗功能和生理结果。所有患者均在一家大都市教学医院参加了结构化吞咽治疗项目。该项目与更传统的吞咽治疗不同之处在于，它将表面肌电图生物反馈作为一种治疗方式，并在干预的第一周完成10小时的直接治疗。通过对病历和患者问卷进行回顾性分析，以获取有关病史、病变部位、先前干预措施以及患者对吞咽恢复的看法等信息。通过电视荧光吞咽造影研究的严重程度评分来衡量，10例患者中有9例在接受1周或10次治疗后，吞咽治疗出现了生理变化。通过治疗1周后、6个月以及治疗后1年的饮食水平耐受性来衡量功能变化。10例患者中有8例能够在胃造瘘管喂养终止后恢复完全经口进食，而2例患者的功能性吞咽未出现长期变化。在恢复完全经口进食的8例患者中，治疗后直至停止管饲的平均持续时间为5.3个月，范围为1至12个月。6例恢复经口进食的患者吞咽功能保持改善，2例患者因新的无关医疗状况恢复了非经口营养。
