治疗口咽癌患者的呼吸-吞咽阶段模式及其与吞咽障碍的关系。
Respiratory-swallow phase patterns and their relationship to swallowing impairment in patients treated for oropharyngeal cancer.
机构信息
Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA.
出版信息
Head Neck. 2010 Apr;32(4):481-9. doi: 10.1002/hed.21209.
BACKGROUND
Unstable respiratory-swallowing coordination has been associated with disorders and disease. The goals of this study were (1) to describe respiratory-swallow patterns in patients with dysphagia consequent to treatments for cancers of the oropharynx and (2) to determine the association between respiratory-swallow patterns, airway invasion, and overall severity of swallowing impairment.
METHODS
This prospective, cross-sectional design compared respiratory-swallow patterns in 20 patients treated for oropharyngeal cancer and 20 healthy, age-matched control participants. Nasal airflow direction was synchronously recorded with videofluoroscopic imaging in participants who swallowed 5-mL thin liquid barium boluses.
RESULTS
Respiratory-swallow patterns differed between groups. Most control participants initiated and completed swallowing bracketed by expiratory airflow. Swallowing in patients often interrupted inspiratory flow and was associated with penetration or aspiration of the bolus.
CONCLUSIONS
We suggest nonexpiratory bracketed respiratory-swallowing phase patterns in patients with oropharyngeal cancer may place patients at greater risk of airway penetration or aspiration during swallowing.
背景
不稳定的呼吸-吞咽协调与疾病有关。本研究的目的是：(1)描述因口咽癌治疗而导致吞咽困难的患者的呼吸-吞咽模式；(2)确定呼吸-吞咽模式、气道侵犯和吞咽障碍整体严重程度之间的关系。
方法
本前瞻性、横断面设计比较了 20 例口咽癌治疗患者和 20 例年龄匹配的健康对照参与者的呼吸-吞咽模式。参与者吞咽 5 毫升稀薄的钡剂时，同步记录鼻气流方向的视频荧光透视图像。
结果
呼吸-吞咽模式在两组之间存在差异。大多数对照组参与者在呼气气流的作用下开始和完成吞咽。而患者的吞咽常常中断吸气流，并伴有吞咽物的渗透或吸入。
结论
我们建议口咽癌患者出现非呼气性呼吸-吞咽相模式可能会增加患者在吞咽时气道穿透或吸入的风险。
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