Serel Arslan Selen, Demir Numan, Karaduman Aynur Ayşe
Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
Clin Respir J. 2018 Feb;12(2):767-771. doi: 10.1111/crj.12592. Epub 2016 Dec 15.
One of the underlying causes of recurrent pneumonia in children is swallowing dysfunction, with aspiration syndrome. Swallowing dysfunction should be considered not only a problem of the oropharyngeal phase but also a problem of the esophageal phase.
This study aimed to determine the relationship between findings from a swallowing study and a history of recurrent pneumonia in pediatric patients.
A videofluroscopic swallowing study of 274 pediatric patients who had swallowing dysfunction was conducted. Information on a history of recurrent pneumonia during a 1-year period was obtained from hospital files.
The median age of the participants was 33 months (min =10, max = 180), of whom 51.8% were females. In the study, 83.2% of the patients had cerebral palsy, 7.7% had syndromic symptoms, 3.6% had muscular dystrophy, and 5.5% were classified as "other." During the 1-year period, 67.9% of the participants had a history of recurrent pneumonia history. Furthermore, 66.4% had oral dysfunction, 32.5% had laryngeal penetration, 46.4% had aspiration, 45.3% had abnormal esophageal body function, and 35.8% had reflux symptoms. There was no correlation between oral dysfunction and recurrent pneumonia (P = .902), but there was a positive correlation between recurrent pneumonia and laryngeal penetration (P < .001, r = .26), aspiration (P < .001, r =.49), abnormal esophageal body function (P = .002, r = .18), and reflux (P < .001, r = .22).
Both pharyngeal swallowing disorders, such as penetration and aspiration, and esophageal disorders and reflux may result in recurrent pneumonia in pediatric patients. Thus, all phases of deglutition should be considered and followed up during swallowing evaluation.
儿童复发性肺炎的潜在病因之一是吞咽功能障碍伴误吸综合征。吞咽功能障碍不应仅被视为口咽期的问题，还应被视为食管期的问题。
本研究旨在确定吞咽研究结果与儿科患者复发性肺炎病史之间的关系。
对274名有吞咽功能障碍的儿科患者进行了视频荧光吞咽研究。从医院档案中获取了患者1年内复发性肺炎病史的信息。
参与者的中位年龄为33个月（最小 = 10，最大 = 180），其中51.8%为女性。在该研究中，83.2%的患者患有脑瘫，7.7%有综合征症状，3.6%有肌肉萎缩症，5.5%被归类为“其他”。在1年期间，67.9%的参与者有复发性肺炎病史。此外，66.4%有口腔功能障碍，32.5%有喉部穿透，46.4%有误吸，45.3%有食管体功能异常，35.8%有反流症状。口腔功能障碍与复发性肺炎之间无相关性（P = 0.902），但复发性肺炎与喉部穿透（P < 0.001，r = 0.26）、误吸（P < 0.001，r = 0.49）、食管体功能异常（P = 0.002，r = 0.18）和反流（P < 0.001，r = 0.22）之间存在正相关。
咽部吞咽障碍，如穿透和误吸，以及食管疾病和反流都可能导致儿科患者复发性肺炎。因此，在吞咽评估期间应考虑并随访吞咽的所有阶段。
