Coelho C A, Ferranti R
Department of Communication Disorders, Gaylord Hospital, Wallingford, CT 06492.
Arch Phys Med Rehabil. 1991 Dec;72(13):1071-5.
Questionnaires pertaining to swallowing function were mailed to 220 members of postpolio support groups in Connecticut. Of the 109 responses, 80 individuals reported having no difficulty with swallowing, while 29 reported having either intermittent or consistent swallowing problems. Twenty-one of the 29 were seen for videofluoroscopic swallowing studies and pulmonary function testing. The swallowing studies showed that 43% of these individuals had difficulty with bolus control, 19% with delayed swallow response, and 81% with decreased pharyngeal transit. Although none of these individuals were observed to aspirate, two were judged to be at significant risk. Incidence of dysphagia within the group of polio survivors was estimated to be approximately 18%. Seventeen of the 20 postpolio subjects with dysphagia also demonstrated decreased breathing capacity. Although moderately to severely depressed values in the pulmonary function measures accompanied moderate dysphagia in certain postpolio individuals, reduced values in these same measures were also present in individuals with minimal swallowing dysfunction. Therefore, although impaired breathing may complicate swallowing dysfunction and vice versa, it does not appear that one can be predicated from the other. Management of dysphagia in postpolio individuals is discussed.
有关吞咽功能的调查问卷被邮寄给了康涅狄格州小儿麻痹症后支持小组的220名成员。在109份回复中，80人报告吞咽没有困难，而29人报告有间歇性或持续性吞咽问题。这29人中的21人接受了视频荧光吞咽研究和肺功能测试。吞咽研究表明，这些人中有43%在食团控制方面有困难，19%有吞咽反应延迟，81%有咽部通过时间缩短。虽然这些人中没有人被观察到有误吸，但有两人被判定有很大风险。小儿麻痹症幸存者群体中吞咽困难的发生率估计约为18%。20名患有吞咽困难的小儿麻痹症患者中有17人也表现出呼吸能力下降。虽然在某些小儿麻痹症患者中，肺功能测量值中度至重度降低伴随着中度吞咽困难，但在吞咽功能障碍最小的个体中也存在这些相同测量值的降低。因此，虽然呼吸受损可能使吞咽功能障碍复杂化，反之亦然，但似乎无法从一方推断另一方。文中讨论了小儿麻痹症患者吞咽困难的管理。
