Suntrup S, Meisel A, Dziewas R, Ende F, Reichmann H, Heuschmann P, Ickenstein G W
Klinik für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus, Münster, Deutschland.
Nervenarzt. 2012 Dec;83(12):1619-24. doi: 10.1007/s00115-012-3611-9.
Due to malnutrition and aspiration pneumonia dysphagia is associated with increased morbidity and mortality in acute stroke patients. Early detection of patients at risk of dysphagia leading to timely treatment improves the outcome.
A survey concerning the current state of dysphagia diagnostics and therapy was carried out among certified stoke units in Germany.
Of the 163 invited hospitals 51% participated in the study. A standardized dysphagia program lying mainly within the responsibility of speech language therapists (64%) is established in 94%. Main elements are swallowing assessments carried out by nurses (72%) and the clinical swallowing examination (93%). Instrumental diagnostics are available in 55% with videoendoscopy (52%) being more widely used than videofluoroscopy (17%). In the acute stage nutrition with texture modified diets is the primary therapeutic strategy.
Structured programs for the diagnosis and treatment of dysphagia have generally been established but individual strategies differ and differences in the quality of care are obvious.
由于营养不良和吸入性肺炎，吞咽困难与急性中风患者的发病率和死亡率增加相关。早期发现有吞咽困难风险的患者并及时治疗可改善预后。
在德国的认证中风单元中开展了一项关于吞咽困难诊断和治疗现状的调查。
在163家受邀医院中，51%参与了研究。94%的医院制定了主要由言语治疗师负责（64%）的标准化吞咽困难计划。主要内容包括护士进行的吞咽评估（72%）和临床吞咽检查（93%）。55%的医院可进行仪器诊断，其中视频内镜检查（52%）的使用比视频荧光透视检查（17%）更为广泛。在急性期，采用质地改良饮食进行营养支持是主要的治疗策略。
吞咽困难的诊断和治疗的结构化计划总体上已经建立，但个体策略存在差异，护理质量的差异也很明显。
