Uhm Kyeong Eun, Yi Sook-Hee, Chang Hyun Jung, Cheon Hee Jung, Kwon Jeong-Yi
Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Rehabil Med. 2013 Apr;37(2):175-82. doi: 10.5535/arm.2013.37.2.175. Epub 2013 Apr 30.
To determine the clinical characteristics and videofluoroscopic swallowing study (VFSS) findings in infants with suspected dysphagia and compare the clinical characteristics and VFSS findings between full-term and preterm infants.
A total of 107 infants (67 full-term and 40 preterm) with suspected dysphagia who were referred for VFSS at a tertiary university hospital were enrolled in this retrospective study. Clinical characteristics and VFSS findings were reviewed by a physiatrist and an experienced speech-language pathologist. The association between the reasons of referral for VFSS and VFSS findings were analyzed.
Mean gestational age was 35.1±5.3 weeks, and mean birth weight was 2,381±1,026 g. The most common reason for VFSS referral was 'poor sucking' in full-term infants and 'desaturation' in preterm infants. The most common associated medical condition was 'congenital heart disease' in full-term infants and 'bronchopulmonary dysplasia' in preterm infants. Aspiration was observed in 42 infants (39.3%) and coughing was the only clinical predictor of aspiration in VFSS. However, 34 of 42 infants (81.0%) who showed aspiration exhibited silent aspiration during VFSS. There were no significant differences in the VFSS findings between the full-term and preterm infants except for 'decreased sustained sucking.'
There are some differences in the clinical manifestations and VFSS findings between full-term and preterm infants with suspected dysphagia. The present findings provide a better understanding of these differences and can help clarify the different pathophysiologic mechanisms of dysphagia in infants.
确定疑似吞咽困难婴儿的临床特征及视频荧光吞咽造影检查(VFSS)结果,并比较足月儿和早产儿的临床特征及VFSS结果。
本回顾性研究纳入了一所三级大学医院中107例因疑似吞咽困难而接受VFSS检查的婴儿(67例足月儿和40例早产儿)。由一名物理治疗师和一名经验丰富的言语语言病理学家对临床特征和VFSS结果进行评估。分析了转诊接受VFSS检查的原因与VFSS结果之间的关联。
平均胎龄为35.1±5.3周,平均出生体重为2381±1026克。足月儿转诊接受VFSS检查的最常见原因是“吸吮无力”,早产儿是“血氧饱和度下降”。足月儿最常见的合并症是“先天性心脏病”,早产儿是“支气管肺发育不良”。42例婴儿(39.3%)观察到有误吸,咳嗽是VFSS中误吸的唯一临床预测指标。然而,42例出现误吸的婴儿中有34例(81.0%)在VFSS期间表现为隐性误吸。除“持续吸吮减少”外,足月儿和早产儿的VFSS结果无显著差异。
疑似吞咽困难的足月儿和早产儿在临床表现及VFSS结果方面存在一些差异。本研究结果有助于更好地理解这些差异,并有助于阐明婴儿吞咽困难的不同病理生理机制。