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[意识障碍中的吞咽问题]

[Swallowing in disorders of consciousness].

作者信息

Bicego A, Lejoly K, Maudoux A, Lefebvre P, Laureys S, Schweizer V, Diserens K, Faymonville M-E, Vanhaudenhuyse A

机构信息

Coma Science Group, centre de recherches du cyclotron, université de Liège, allée du 6-Août, Sart Tilman B30, 4000 Liège, Belgique.

Coma Science Group, centre de recherches du cyclotron, université de Liège, allée du 6-Août, Sart Tilman B30, 4000 Liège, Belgique; Service d'oto-rhino-laryngologie, hôpital universitaire de Liège, université de Liège, 13, avenue de l'Hôpital, 4000 Liège, Belgique.

出版信息

Rev Neurol (Paris). 2014 Oct;170(10):630-41. doi: 10.1016/j.neurol.2014.04.004. Epub 2014 Jun 18.

Abstract

INTRODUCTION

Interest in studying swallowing disorders in patients with altered consciousness has increased over the past decade. Swallowing deficit is frequently encountered in severe brain-injured patients.

STATE OF ART

Results of studies have highlighted different factors such as the delay between the injury and the treatment and the level of consciousness of these patients, as well as the presence or not of tracheotomy, which will determine the feasibility of resuming oral feeding. Nowadays, very few valid and sensitive scales can be used to assess swallowing deficit in patients with disorders of consciousness. The Facial Oral Tract Therapy (FOTT) scale is an inter-professional multidisciplinary approach offering a structured way to evaluate and treat patients with swallowing disorders. In contrast with other scales, patients do not have to follow verbal instructions for the FOTT.

PERSPECTIVES

This paper presents a review of existing literature on the assessment and management of swallowing disorders in patients with altered state of consciousness, and a description of the FOTT method.

CONCLUSION

The FOTT seems to be an interesting assessment and rehabilitation tool for patients with disorders of consciousness. However, clinical studies are needed to confirm the validity and sensitivity of this technique.

摘要

引言

在过去十年中,对意识改变患者吞咽障碍的研究兴趣有所增加。吞咽功能缺陷在重度脑损伤患者中经常出现。

现状

研究结果强调了不同因素,如损伤与治疗之间的延迟、这些患者的意识水平,以及气管切开术的有无,这些因素将决定恢复经口进食的可行性。如今,很少有有效且敏感的量表可用于评估意识障碍患者的吞咽功能缺陷。面部口腔道治疗(FOTT)量表是一种跨专业的多学科方法,提供了一种结构化的方式来评估和治疗吞咽障碍患者。与其他量表不同,FOTT量表患者无需遵循口头指示。

展望

本文对意识状态改变患者吞咽障碍的评估和管理的现有文献进行了综述,并对FOTT方法进行了描述。

结论

FOTT量表似乎是一种用于意识障碍患者的有趣评估和康复工具。然而,需要进行临床研究以证实该技术的有效性和敏感性。

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