Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Research Group on Geriatrics at Ev. Geriatriezentrum Berlin, Reinickendorfer Straße 61, 13347, Berlin, Germany.
Dysphagia. 2011 Jun;26(2):108-16. doi: 10.1007/s00455-009-9270-8. Epub 2010 Jan 26.
Functional dysphagia therapy (FDT) is a noninvasive procedure that can accompany percutaneous endoscopic gastrostomy (PEG) treatment and supports transitioning from tube to oral feeding. In this retrospective study, we investigated the outcome of FDT with or without PEG feeding. Patients with dysphagia were divided into two groups: those with PEG feeding (N = 117) and those with exclusively oral feeding (N = 105). Both groups received functional training (oral motor skills/sensation, compensatory swallowing techniques) from speech-language therapists. Functional oral intake, weight, Barthel index, and speech and language abilities were evaluated pre- and post-training. The non-PEG group showed a significant post-treatment improvement in functional oral intake, with diet improvement from pasty consistency to firm meals in most cases. However, even severely disordered patients (with PEG feeding) showed a significant increase in functional oral intake, still requiring PEG feeding post-treatment but able to take some food orally. The sooner a PEG was placed, the more functional oral intake improved. Significantly more complications and higher mortality occurred in the PEG group compared to the group with exclusively oral feeding. Dysphagia treatment in the elderly requires a multiprofessional setting, differentiated assessment, and functional training of oral motor skills and sensation and swallowing techniques.
功能性吞咽障碍治疗（FDT）是一种非侵入性的治疗方法，可与经皮内镜下胃造瘘术（PEG）治疗同时进行，并支持从管饲向口服喂养过渡。在这项回顾性研究中，我们研究了 FDT 联合或不联合 PEG 喂养的治疗效果。将吞咽困难患者分为两组：接受 PEG 喂养的患者（N=117）和仅接受口服喂养的患者（N=105）。两组患者均接受语言治疗师的功能训练（口腔运动技能/感觉、代偿性吞咽技术）。在治疗前后评估功能性口服摄入、体重、巴氏指数以及言语和语言能力。非 PEG 组在治疗后功能性口服摄入明显改善，大多数情况下饮食从糊状变为固体餐。然而，即使是严重吞咽障碍的患者（接受 PEG 喂养），功能性口服摄入也显著增加，尽管治疗后仍需要 PEG 喂养，但能够经口摄入一些食物。PEG 放置得越早，功能性口服摄入改善得越多。与仅接受口服喂养的患者相比，PEG 组发生并发症和死亡率更高。老年人的吞咽障碍治疗需要多专业团队、差异化评估以及口腔运动技能和感觉以及吞咽技术的功能训练。
