内镜医师在卒中单元中的作用。
The Role of the Endoscopist in the Stroke Unit.
作者信息
Frieling Thomas
机构信息
Department of Gastroenterology, Hepatology, Infectiology, Neurogastroenterology, Hematology, Oncology, and Palliative Medicine, HELIOS-Clinic Krefeld, Krefeld, Germany.
出版信息
Visc Med. 2016 Feb;32(1):53-7. doi: 10.1159/000443656. Epub 2016 Feb 2.
BACKGROUND
Acute cerebral stroke is a common problem that is frequently associated with dysphagia resulting in an increased risk of aspiration pneumonia, complication, and mortality.
METHODS
A literature review was carried out using the search terms 'stroke unit and endoscopy', 'stroke unit and dysphagia', and 'stroke unit and gastroenterology'.
RESULTS
Only few papers focus on the role of endoscopy in stroke units. One major role is the early detection of dysphagia by flexible endoscopic evaluation of swallowing (FEES). FEES appears to have a higher sensitivity and specificity compared to bedside tests and challenges videofluoroscopy. In contrast, other stroke-associated gastrointestinal complications requiring endoscopic diagnostic or therapeutic intervention, such as gastrointestinal bleeding, abdominal pain, or stasis, and the need to provide fluid and food via gastrostomy or jejunostomy are rarely seen in stroke units and become relevant during and after the rehabilitation phase.
CONCLUSION
FEES should involve an interdisciplinary team comprising neurologists, speech and language pathologists and/or therapists, as well as gastroenterologic endoscopists.
背景
急性脑卒是一个常见问题，常伴有吞咽困难，导致误吸性肺炎、并发症及死亡率增加。
方法
使用检索词“卒中单元与内镜检查”、“卒中单元与吞咽困难”、“卒中单元与胃肠病学”进行文献综述。
结果
仅有少数论文关注内镜检查在卒中单元中的作用。一个主要作用是通过吞咽功能的柔性内镜评估（FEES）早期检测吞咽困难。与床边检查相比，FEES似乎具有更高的敏感性和特异性，并且对视频透视检查构成挑战。相比之下，其他需要内镜诊断或治疗干预的与卒中相关的胃肠道并发症，如胃肠道出血、腹痛或淤滞，以及通过胃造口术或空肠造口术提供液体和食物的需求，在卒中单元中很少见，且在康复阶段期间及之后才变得重要。
结论
FEES应由包括神经科医生、言语和语言病理学家及/或治疗师以及胃肠病内镜医师在内的多学科团队进行。
Zotero 插件