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吞咽功能障碍作为复发性肺炎中应予以重视的一个因素:电视荧光吞咽造影检查

Swallowing dysfunction as a factor that should be remembered in recurrent pneumonia: videofluoroscopic swallow study.

作者信息

Kaymaz Nazan, Özçelik Uğur, Demir Numan, Cinel Güzin, Yalçin Ebru, Ersöz Deniz D, Kiper Nural

机构信息

Department of Pediatrics, Faculty of Medicine, Canakkale Onsekiz Mart University, Çanakkale, Turkey -

Pulmology Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

Minerva Pediatr. 2017 Oct;69(5):396-402. doi: 10.23736/S0026-4946.16.04245-6. Epub 2015 Sep 10.

Abstract

BACKGROUND

The swallow function is one of the strong defense mechanism against aspiration. Aspiration and pneumonia are unavoidable in patients with defective mechanism of swallowing. The aim of this study was to evaluate patients with recurrent pneumonia in terms of videofluoroscopic examination results.

METHODS

The study comprised fifty pediatric cases (22 boys, 28 girls) with an average age of 2.9 years (2 months-7.5 years) who were referred to our clinic due to suffering from recurrent pneumonia. The videofluoroscopic swallow study (VFSS) was performed on all patients. The presence of a correlation with pneumonia was investigated.

RESULTS

In 45 of the children, VFSS results were not normal. Of the children, 41 had mental-motor retardation. The results of the videofluoroscopic study show that silent aspiration was the most common pathology in participants with the percentage of 40 (27.5% mild, 17.5% severe). Patients in the study had pneumonia with an incidence of 2.6 illnesses per year. Having one than more results on VFSS was found to be associated with more number of annual pneumonia episodes.

CONCLUSIONS

Children with neurological impairments are at risk of recurrent acute pneumonia due to aspiration. Disturbances of swallowing phases should be remembered as a cause of pneumonia in these patients.

摘要

背景

吞咽功能是预防误吸的强大防御机制之一。吞咽机制有缺陷的患者不可避免地会发生误吸和肺炎。本研究的目的是根据视频荧光透视检查结果评估复发性肺炎患者。

方法

该研究包括五十例儿科病例(22名男孩,28名女孩),平均年龄2.9岁(2个月至7.5岁),因患复发性肺炎转诊至我院门诊。对所有患者进行视频荧光透视吞咽研究(VFSS)。调查其与肺炎的相关性。

结果

45名儿童的VFSS结果不正常。其中41名儿童有精神运动发育迟缓。视频荧光透视研究结果显示,隐性误吸是参与者中最常见的病理情况,占40%(轻度27.5%,重度17.5%)。研究中的患者每年患肺炎的发病率为2.6次。发现VFSS结果一项以上异常与每年肺炎发作次数较多有关。

结论

神经功能受损的儿童因误吸有复发性急性肺炎的风险。对于这些患者,应记住吞咽阶段紊乱是肺炎的一个病因。

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