Wirth R, Dziewas R
Klinik für Altersmedizin und Frührehabilitation, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
Klinik für Allgemeine Neurologie, Universitätsklinik Münster, Münster, Deutschland.
Internist (Berl). 2017 Feb;58(2):132-140. doi: 10.1007/s00108-016-0178-8.
Approximately half of neurological and geriatric inpatients suffer from oropharyngeal dysphagia. This often leads to pneumonia, malnutrition and dehydration; however, the underlying dysphagia is frequently not diagnosed and treated. This is particularly the case for patients with so-called silent aspiration. Knowledge on the physiology of swallowing, including the central nervous system control of swallowing and the therapeutic options have achieved considerable progress in recent years. In particular, the increasing implementation of flexible endoscopic evaluation of swallowing (FEES) has significantly contributed to this knowledge. It provides the ability to identify the individual pattern of oropharyngeal dysphagia leading to a suitable selection of therapeutic and compensatory strategies for individual patients. The various therapeutic options range from modification of the consistency of the diet, over diverse logopedic strategies and stimulation techniques up to interventional procedures.
约一半的神经科和老年科住院患者患有口咽吞咽困难。这常常导致肺炎、营养不良和脱水；然而，潜在的吞咽困难往往未得到诊断和治疗。对于所谓的隐性误吸患者而言尤其如此。近年来，关于吞咽生理学的知识，包括吞咽的中枢神经系统控制及治疗选择等方面都取得了显著进展。特别是，越来越多地实施的吞咽功能的软性内镜评估（FEES）对这方面知识的增长做出了重大贡献。它能够识别口咽吞咽困难的个体模式，从而为个体患者选择合适的治疗和代偿策略。各种治疗选择包括改变饮食的质地，从各种言语治疗策略和刺激技术到介入手术。
