Ward Elizabeth C, Green Karly, Morton Ann-Louise
Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.
J Head Trauma Rehabil. 2007 May-Jun;22(3):184-91. doi: 10.1097/01.HTR.0000271119.96780.f5.
To examine the patterns of swallowing resolution and outcomes of traumatic brain injury (TBI) patients in an acute care setting and document the risk factors or predictors of resolution of swallowing function.
117 consecutive TBI patients who had received speech pathology intervention for dysphagia during acute postinjury care.
Temporal measures relating to pattern of resolution of dysphagia postinjury.
75% of patients were assessed by 2 weeks postinjury, commenced oral intake by 17 days, and ceased supplementation by 3 weeks. By an average of 22 days after admission, 47% had progressed to normal-consistency diet and fluids. Duration to the first swallowing assessment was a predictor for achieving total oral intake and returning to normal intake. There was some preliminary support for severity of CT data and presence/absence of a tracheostomy as predictors for return to normal intake.
The current data document the natural history of swallowing resolution and proposes prognostic factors for patients with impaired swallowing following TBI. Establishing clinical parameters that can help predict patterns of swallowing resolution over the course of acute care admission may greatly assist inpatient management and discharge/rehabilitation planning.
研究急性护理环境中创伤性脑损伤（TBI）患者吞咽功能恢复模式及预后情况，并记录吞咽功能恢复的风险因素或预测指标。
117例连续的TBI患者，这些患者在伤后急性期接受了针对吞咽困难的言语病理学干预。
与伤后吞咽困难恢复模式相关的时间指标。
75%的患者在伤后2周内接受评估，17天开始经口进食，3周停止补充营养。入院平均22天后，47%的患者已过渡到正常质地的饮食和液体摄入。首次吞咽评估的时间是实现完全经口进食和恢复正常饮食的预测指标。CT数据严重程度和是否行气管切开术作为恢复正常饮食的预测指标有一些初步依据。
目前的数据记录了吞咽功能恢复的自然病程，并提出了TBI后吞咽功能受损患者的预后因素。确定有助于预测急性护理入院期间吞咽功能恢复模式的临床参数，可能会极大地帮助住院患者管理及出院/康复计划制定。
