Vesey Siobhan
Speech and Language Therapy Department, Trafford General Hospital, UK.
Br J Community Nurs. 2013 May;Suppl:S14, S16, S18-9. doi: 10.12968/bjcn.2013.18.sup5.s14.
Swallowing difficulties can be a symptom of many different disease processes, and are associated with adverse health outcomes; malnutrition, dehydration, pneumonia and death. The use of feeding tubes directly into the stomach as in percutaneous endoscopic gastrosomy (PEG) is an increasingly common treatment option for these patients with more and more being cared for in the community. Living with a gastrostomy tube brings physical and emotional impacts and direct consequences for quality of life. Guidance from the Royal College of Physicians recommends 'nil by mouth' should be a last resort even when swallow function is deemed unsafe. Impaired swallowing can cause increased anxiety and fear. Many patients avoid oral intake leading to malnutrition, isolation and depression. Understanding and balancing the risks and potential benefits of continuing oral intake or choosing gastrostomy makes this a complex and challenging area of health care.
吞咽困难可能是许多不同疾病过程的症状，并与不良健康后果相关，如营养不良、脱水、肺炎和死亡。像经皮内镜胃造口术（PEG）那样直接将饲管插入胃内，对于这些患者来说是一种越来越常见的治疗选择，并且越来越多的患者在社区中得到照料。带着胃造口管生活对生活质量会产生身体和情感上的影响以及直接后果。皇家内科医师学院的指南建议，即使吞咽功能被认为不安全，“禁食”也应是最后的手段。吞咽受损会导致焦虑和恐惧加剧。许多患者避免经口摄入，从而导致营养不良、孤立和抑郁。理解并权衡继续经口摄入或选择胃造口术的风险和潜在益处，使得这成为医疗保健中一个复杂且具有挑战性的领域。
