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[急性病毒性细支气管炎婴儿吞咽困难的临床体征]

[Clinical signs of dysphagia in infants with acute viral bronchiolitis].

作者信息

Barbosa Lisiane De Rosa, Gomes Erissandra, Fischer Gilberto Bueno

机构信息

Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil.

Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil.

出版信息

Rev Paul Pediatr. 2014 Sep;32(3):157-63. doi: 10.1590/0103-0582201432302. Epub 2014 Oct 3.

Abstract

OBJECTIVE

: To determine the occurrence of clinical signs of dysphagia in infants with acute viral bronchiolitis, to compare the respiratory parameters during deglutition, and to ensure the intra- and inter- examiners agreement, as well as to accomplish intra and interexaminators concordance of the clinical evaluation of the deglutition.

METHODS

: This was a cross-sectional study of 42 infants aged 0-12 months. The clinical evaluation was accompanied by measurements of respiratory rate and pulse oximetry. A score of swallowing disorders was designed to establish associations with other studied variables and to ensure the intra- and interrater agreement of clinical feeding assessments. Caregivers also completed a questionnaire about feeding difficulties. Significance was set at <0.05.

RESULTS

: Changes in the oral phase (prolonged pauses) and pharyngeal phase (wheezing, coughing and gagging) of swallowing were found. A significant increase in respiratory rate between pre- and post-feeding times was found, and it was determined that almost half of the infants had tachypnea. An association was observed between the swallowing disorder scores and a decrease in oxygen saturation. Infants whose caregivers reported feeding difficulties during hospitalization stated a significantly greater number of changes in the swallowing evaluation. The intra-rater agreement was considered to be very good.

CONCLUSIONS

: Infants with acute viral bronchiolitis displayed swallowing disorders in addition to changes in respiratory rate and measures of oxygen saturation. It is suggested, therefore, that infants displaying these risk factors have a higher probability of dysphagia.

摘要

目的

确定急性病毒性细支气管炎婴儿吞咽困难临床体征的发生率,比较吞咽时的呼吸参数,确保检查者内部和检查者之间的一致性,以及实现吞咽临床评估的检查者内部和检查者之间的一致性。

方法

这是一项对42名0至12个月大婴儿的横断面研究。临床评估同时测量呼吸频率和脉搏血氧饱和度。设计了吞咽障碍评分,以建立与其他研究变量的关联,并确保临床喂养评估的检查者内部和检查者之间的一致性。照顾者还完成了一份关于喂养困难的问卷。显著性设定为<0.05。

结果

发现吞咽的口腔期(延长停顿)和咽期(喘息、咳嗽和作呕)有变化。发现喂食前后呼吸频率显著增加,并且确定几乎一半的婴儿有呼吸急促。观察到吞咽障碍评分与血氧饱和度降低之间存在关联。其照顾者报告住院期间有喂养困难的婴儿在吞咽评估中的变化显著更多。检查者内部一致性被认为非常好。

结论

急性病毒性细支气管炎婴儿除了呼吸频率和血氧饱和度测量值变化外,还表现出吞咽障碍。因此,建议显示这些危险因素的婴儿吞咽困难的可能性更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/110b/4227334/4ae3710a3c61/0103-0582-rpp-32-03-0157-gf01.jpg

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