Mizuno Yuji, Soebijanto Keiji, Sasazuki Momoko, Sakamoto Kei, Aibe Miyuki
Department of Pediatrics, Fukuoka-Higashi Medical Center, Koga, Fukuoka.
No To Hattatsu. 2008 Nov;40(6):456-9.
A total of 43 patients with severe motor and intellectual disabilities were enrolled in videofiberscopic investigation of laryngeal abnormalities. Their ages ranged from 2 to 41 years (mean: 19.9 years) and all of them had severe quadriplegia due to cerebral palsy or other conditions. Thirty-two out of the 43 patients (74.4%) had laryngeal abnormalities;laryngeal stenosis including that of iatrogenic origin, hypersecretion and laryngomalacia. Direct visualization of the occurrence of aspiration could be achieved in some patients. Seven (87.5%) out of 8 patients with tracheostomy and 25 (71.4%) out of 35 patients without tracheostomy had laryngeal abnormalities, showing no significant difference. The prevalence of abnormalities was significantly higher in patients with parenteral nutrition (30/33 = 90.9%) than in those with oral feeding (2/10 = 20%). Endoscopic investigation of the larynx is important, and videofiberscopy is especially effective for evaluation of laryngeal abnormalities in severely handicapped patients.
共有43例严重运动和智力残疾患者接受了喉镜异常的视频纤维镜检查。他们的年龄在2岁至41岁之间（平均19.9岁），所有患者均因脑瘫或其他疾病导致严重四肢瘫痪。43例患者中有32例（74.4%）存在喉部异常；包括医源性起源的喉狭窄、分泌过多和喉软化症。在一些患者中可以直接观察到误吸的发生。8例气管切开患者中有7例（87.5%）和35例未行气管切开患者中有25例（71.4%）存在喉部异常，差异无统计学意义。接受肠外营养的患者（30/33 = 90.9%）异常发生率明显高于经口喂养的患者（2/10 = 20%）。喉部的内镜检查很重要，视频纤维镜检查对于评估重度残疾患者的喉部异常尤其有效。
