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口咽吞咽困难患者经电视透视吞咽功能检查的咽残留与误吸及其与临床/营养状况的关系

Pharyngeal Residue and Aspiration and the Relationship with Clinical/Nutritional Status of Patients with Oropharyngeal Dysphagia Submitted to Videofluoroscopy.

作者信息

Oliveira D L, Moreira E A M, de Freitas M B, Gonçalves J de A, Furkim A M, Clavé P

机构信息

Emilia Addison Machado Moreira, Departamento de Nutrição, Universidade Federal de Santa Catarina UFSC. Campus Universitário, Trindade, s/n, Florianópolis, Santa Catarina, Brazil. Zip Code: 88.040-970. Phone: +55 48 37219784, Fax: +55 48 37219542, E-mail address:

出版信息

J Nutr Health Aging. 2017;21(3):336-341. doi: 10.1007/s12603-016-0754-6.

Abstract

OBJECTIVES

The aim of this study was to investigate the association between the videofluoroscopic (VFS) signs of impaired efficacy (pharyngeal residue) and safety (aspiration) swallowing and the clinical/nutritional status of patients with suspect of dysphagia.

DESIGN

A cross-sectional study was conducted with patients submitted to videofluoroscopy.

SETTING AND PARTICIPANTS

Data of 76 patients were analyzed between March 2011 and December 2014.

MEASUREMENTS

The clinical history and VFS exams of patients ≥ 38 years were retrospectively analyzed.

RESULTS

88% patients presented Oropharyngeal Dysphagia (OD), 44.7% presented laryngeal penetration and 32% presented aspiration. 78% patients presented pharyngeal residue. Aspiration was associated with Head Neck Cancer (HNC) [Prevalence Ratio (PR): 2.27, p = 0.028] and cardiovascular disease (PR 1.96, p = 0.027). Underweight [Body Mass Index < 18.5 kg/m2] was not associated with the presence of aspiration. Underweight patients with OD had a higher prevalence rate of pharyngeal residue than those normally nourished (100% vs. 78%) (PR 1.34, p = 0.011). Pharyngeal residue was associated with male sex (PR 1.32, p = 0.040), neurodegenerative disease (PR 1.57, p = 0.021), stroke (PR 1.62, p = 0.009), cerebral palsy (PR 1.76, p = 0.006) and HNC (PR 1.73, p = 0.002).

CONCLUSION

In the present study, neurologic diseases, HNC, male sex and underweight were associated to impaired swallowing efficacy. Underweight, independently of the other variables, was not associated with impaired swallowing safety.

摘要

目的

本研究旨在调查电视荧光吞咽造影(VFS)中有效性受损(咽部残留)和安全性(误吸)吞咽征象与吞咽困难疑似患者的临床/营养状况之间的关联。

设计

对接受电视荧光吞咽造影的患者进行横断面研究。

设置与参与者

分析了2011年3月至2014年12月期间76例患者的数据。

测量

对年龄≥38岁患者的临床病史和VFS检查进行回顾性分析。

结果

88%的患者存在口咽吞咽困难(OD),44.7%的患者存在喉穿透,32%的患者存在误吸。78%的患者存在咽部残留。误吸与头颈癌(HNC)[患病率比(PR):2.27,p = 0.028]和心血管疾病(PR 1.96,p = 0.027)相关。体重过轻[体重指数<18.5 kg/m²]与误吸的存在无关。患有OD的体重过轻患者咽部残留的患病率高于营养正常者(100%对78%)(PR 1.34,p = 0.011)。咽部残留与男性(PR 1.32,p = 0.040)、神经退行性疾病(PR 1.57,p = 0.021)、中风(PR 1.62,p = 0.009)、脑瘫(PR 1.76,p = 0.006)和HNC(PR 1.73,p = 0.002)相关。

结论

在本研究中,神经系统疾病、HNC、男性和体重过轻与吞咽有效性受损相关。体重过轻独立于其他变量,与吞咽安全性受损无关。

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