Lee Won Kyung, Yeom Jiwoon, Lee Woo Hyung, Seo Han Gil, Oh Byung-Mo, Han Tai Ryoon
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Rehabilitation Medicine, Gangwon-Do Rehabilitation Hospital, Chuncheon, Korea.
Ann Rehabil Med. 2016 Jun;40(3):432-9. doi: 10.5535/arm.2016.40.3.432. Epub 2016 Jun 29.
To compare the swallowing characteristics of dysphagic patients with traumatic brain injury (TBI) with those of dysphagic stroke patients.
Forty-one patients with TBI were selected from medical records (between December 2004 to March 2013) and matched to patients with stroke (n=41) based on age, sex, and disease duration. Patients' swallowing characteristics were analyzed retrospectively using a videofluoroscopic swallowing study (VFSS) and compared between both groups. Following thorough review of medical records, patients who had a history of diseases that could affect swallowing function at the time of the study were excluded. Dysphagia characteristics and severity were evaluated using the American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale, clinical dysphagia scale, and the videofluoroscopic dysphagia scale.
There was a significant difference in radiological lesion location (p=0.024) between the two groups. The most common VFSS finding was aspiration or penetration, followed by decreased laryngeal elevation and reduced epiglottis inversion. Swallowing function, VFSS findings, or quantified dysphagia severity showed no significant differences between the groups. In a subgroup analysis of TBI patients, the incidence of tube feeding was higher in patients with surgical intervention than in those without (p=0.011).
The swallowing characteristics of dysphagic patients after TBI were comparable to those of dysphagic stroke patients. Common VFSS findings comprised aspiration or penetration, decreased laryngeal elevation, and reduced epiglottis inversion. Patients who underwent surgical intervention after TBI were at high risk of tube feeding requirement.
比较创伤性脑损伤（TBI）吞咽困难患者与中风吞咽困难患者的吞咽特征。
从病历中选取41例TBI患者（2004年12月至2013年3月期间），并根据年龄、性别和病程与中风患者（n = 41）进行匹配。使用视频荧光吞咽造影检查（VFSS）对患者的吞咽特征进行回顾性分析，并在两组之间进行比较。在全面审查病历后，排除在研究时具有可能影响吞咽功能疾病史的患者。使用美国言语语言听力协会国家结局测量系统吞咽量表、临床吞咽困难量表和视频荧光吞咽困难量表评估吞咽困难特征和严重程度。
两组之间的放射学病变位置存在显著差异（p = 0.024）。最常见的VFSS表现是误吸或渗透，其次是喉提升降低和会厌反转减少。两组之间的吞咽功能、VFSS表现或量化的吞咽困难严重程度无显著差异。在TBI患者的亚组分析中，接受手术干预的患者管饲发生率高于未接受手术干预的患者（p = 0.011）。
TBI后吞咽困难患者的吞咽特征与中风吞咽困难患者的吞咽特征相当。常见的VFSS表现包括误吸或渗透、喉提升降低和会厌反转减少。TBI后接受手术干预的患者有较高的管饲需求风险。
