Field L H, Weiss C J
Department of Rehabilitation Medicine, State University of New York, Buffalo.
Brain Inj. 1989 Jan-Mar;3(1):19-26. doi: 10.3109/02699058909008069.
This retrospective study was conducted: (1) to establish the incidence of dysphagia with head injury, (2) to demonstrate the capabilities of videofluorography (VFG) in identifying the common areas of swallowing dysfunction, and (3) to demonstrate the dysphagia management advantages of the VFG. Nine patients (30%) were found to have significant swallowing problems among 30 patients admitted to the Head Injury Program, Erie County Medical Center, Buffalo, NY in 9 months. These nine patients represent 4.5% of all head-injured patients admitted. The most common swallowing problems demonstrated by videofluorography barium swallow were prolonged oral transit and delayed swallowing reflex; each occurring in 87.5% of eight cases. The study revealed a high correlation between swallowing dysfunction and prolonged hospitalization. Serial VFGs document improved swallowing function, and indicate when relatively safe cessation of nasogastric tube feedings can be achieved. This may permit shorter hospitalization.
(1)确定头部损伤后吞咽困难的发生率;(2)展示视频荧光吞咽造影(VFG)在识别吞咽功能障碍常见部位方面的能力;(3)展示VFG在吞咽困难管理方面的优势。在纽约州布法罗市伊利县医疗中心头部损伤项目组9个月内收治的30例患者中,9例(30%)被发现存在明显的吞咽问题。这9例患者占所有入院头部受伤患者的4.5%。视频荧光吞咽造影钡餐检查显示,最常见的吞咽问题是口腔运送时间延长和吞咽反射延迟;在8例患者中,每种情况的发生率均为87.5%。研究表明吞咽功能障碍与住院时间延长之间存在高度相关性。连续的VFG记录了吞咽功能的改善情况,并指明何时可以相对安全地停止鼻饲管喂养。这可能会缩短住院时间。