Blitzer A
Division of Head and Neck Surgery, Columbia-Presbyterian Medical Center, New York, New York 10032.
Dysphagia. 1990;5(3):129-37. doi: 10.1007/BF02412635.
Aspiration, or soiling of the tracheobronchial tree, can produce life-threatening pulmonary disease. Intermittent or persistent aspiration may cause symptoms including cough, intermittent fever, recurrent tracheobronchitis, atelectasis, pneumonia, and/or empyema. The pulmonary disease may be associated with weight loss, cachexia, and dehydration. In many cases the aspiration is caused by laryngeal dysfunction, allowing pulmonary contamination by swallowed material. In other cases the aspiration is caused by a dysfunction of the oral, pharyngeal, or esophageal phases of swallowing. In some cases the aspiration is caused by a combination of laryngeal and swallowing dysfunction. Geriatric patients are more likely to experience aspiration, since muscle weakness causing mechanical disability and neurologic impairment are more common in this age group. Therefore, with the ever-increasing aging of our population, these disabilities will be on the rise, with an associated increase in pulmonary disease and death. The approach to evaluation and management of these disorders must be based on an understanding of the underlying functional impairment.
气道吸入,即气管支气管树被污染,可导致危及生命的肺部疾病。间歇性或持续性吸入可能引起咳嗽、间歇性发热、复发性气管支气管炎、肺不张、肺炎和/或脓胸等症状。肺部疾病可能与体重减轻、恶病质和脱水有关。在许多情况下,吸入是由喉部功能障碍引起的,导致吞咽物质污染肺部。在其他情况下,吸入是由吞咽的口腔、咽部或食管阶段功能障碍引起的。在某些情况下,吸入是由喉部和吞咽功能障碍共同引起的。老年患者更容易发生吸入,因为导致机械性残疾和神经功能损害的肌肉无力在这个年龄组中更为常见。因此,随着我国人口老龄化的不断加剧,这些残疾将会增加,随之而来的是肺部疾病和死亡人数的增加。对这些疾病的评估和管理方法必须基于对潜在功能损害的理解。