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吞咽时间延长与伴有吸入性肺炎的帕金森病吞咽困难患者相关。

Prolonged swallowing time in dysphagic Parkinsonism patients with aspiration pneumonia.

机构信息

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, and College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.

出版信息

Arch Phys Med Rehabil. 2012 Nov;93(11):2080-4. doi: 10.1016/j.apmr.2012.07.010. Epub 2012 Jul 27.

Abstract

OBJECTIVE

To quantitatively measure which dysphagic features, including swallowing time and hyoid bone displacement, would be associated with increased risk of aspiration pneumonia in dysphagic Parkinsonism patients.

DESIGN

Clinical survey.

SETTING

Tertiary care center.

PARTICIPANTS

Patients with Parkinsonism and dysphagia (N=25), referred for videofluoroscopic swallowing study, were recruited by retrospective review of medical records. They were divided into 2 groups according to the history of aspiration pneumonia.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Swallowing time including onset of pharyngeal swallowing, oral transit time and pharyngeal transit time, and maximum hyoid bone displacement including total, horizontal, and vertical displacement during swallowing in thin and thick bariums were recorded.

RESULTS

Patients with history of aspiration pneumonia had significantly longer pharyngeal transit time (4.14 vs 2.31s, P=.038) and onset of pharyngeal swallowing (2.16 vs 1.04s, P=.031) than those without, when swallowing thin barium. Patients with aspiration pneumonia also had significantly longer swallowing time when swallowing thick barium (oral transit time: 7.14 vs 2.33s, P=.018; pharyngeal transit time: 6.39 vs 1.23s, P=.004; onset of pharyngeal swallowing: 5.11 vs .31s, P=.006). There was no significant difference in hyoid bone displacement between the 2 groups.

CONCLUSIONS

Patients with Parkinsonism dysphagia and aspiration pneumonia had longer swallowing time than those without, but there was no difference in displacement of hyoid bone.

摘要

目的

定量测量吞咽困难的特征,包括吞咽时间和舌骨位移,与吞咽困难帕金森病患者发生吸入性肺炎的风险增加相关。

设计

临床调查。

设置

三级护理中心。

参与者

吞咽困难的帕金森病患者(N=25),通过病历回顾回顾性招募,进行视频透视吞咽研究。他们根据吸入性肺炎的病史分为两组。

干预措施

不适用。

主要观察指标

吞咽时间,包括咽期吞咽开始、口腔通过时间和咽通过时间,以及吞咽薄钡和厚钡时最大的舌骨位移,包括总位移、水平位移和垂直位移。

结果

有吸入性肺炎史的患者在吞咽薄钡时,咽通过时间(4.14 秒比 2.31 秒,P=.038)和咽期吞咽开始(2.16 秒比 1.04 秒,P=.031)明显长于无吸入性肺炎史的患者。吸入性肺炎患者在吞咽厚钡时吞咽时间也明显延长(口腔通过时间:7.14 秒比 2.33 秒,P=.018;咽通过时间:6.39 秒比 1.23 秒,P=.004;咽期吞咽开始:5.11 秒比 3.1 秒,P=.006)。两组间的舌骨位移无显著差异。

结论

帕金森病吞咽困难伴吸入性肺炎患者的吞咽时间长于无吸入性肺炎者,但舌骨位移无差异。

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