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应用于吞咽困难人群的吞咽功能客观测量:一年经验

Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience.

作者信息

Kendall Katherine A, Ellerston Julia, Heller Amanda, Houtz Daniel R, Zhang Chong, Presson Angela P

机构信息

Voice Disorders Center, University of Utah, Salt Lake City, UT, USA.

Division of Otolaryngology, Head & Neck Surgery, University of Utah, 50 Medical Drive, SOM Room 3C120, Salt Lake City, UT, 84132, USA.

出版信息

Dysphagia. 2016 Aug;31(4):538-46. doi: 10.1007/s00455-016-9711-0. Epub 2016 Apr 22.

Abstract

Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p < 0.001) and central neurologic insult. In general, dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology.

摘要

吞咽生理学的定量、可靠测量可通过改良的吞咽钡剂造影研究来进行。这些定量测量此前尚未用于研究大量吞咽困难患者群体。本回顾性研究对一所大学三级嗓音与吞咽诊所连续收治的139例吞咽困难患者进行了研究,旨在使用吞咽生理学的客观测量方法来:(1)量化患者群体中最普遍的缺陷;(2)识别常见的相关诊断并描述最普遍的吞咽缺陷;(3)确定客观缺陷与饮食评估工具(EAT-10)评分及体重指数之间的任何相关性。咽缩功能差(34.5%)和气道保护缺陷(65.5%)是最常见的吞咽异常情况。反流相关性吞咽困难(36%)、非特异性咽吞咽困难(24%)、帕金森病(16%)、食管异常(13%)和脑损伤(10%)是最常见的诊断。咽缩功能差与食管动力异常(p<0.001)和中枢神经损伤显著相关。总体而言,EAT-10所确定的吞咽困难症状与吞咽功能异常并无相关性。这项初步研究表明,反流性疾病在吞咽困难患者中很常见,且相关的食管异常在吞咽困难人群中也很常见,可能与特定的咽吞咽异常有关。然而,EAT-10的症状评分与吞咽病理生理学并不相符。

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