Simons Janine A
University of Lübeck, Lübeck, Germany.
Int Rev Neurobiol. 2017;134:1207-1238. doi: 10.1016/bs.irn.2017.05.026. Epub 2017 Jul 13.
Dysphagia is a very frequent and highly relevant symptom in Parkinson's disease (PD) for quality of life, morbidity, and remaining lifetime, which is unfortunately widely underdiagnosed and underestimated regarding patients' centered care. Especially in early stages, the causal association between disease and swallowing disabilities remains unnoticed, which may be accounted for by the inability of caregivers and physicians to detect subtle swallowing problems and by the low self-awareness among PD patients. In order to prevent patients from serious negative consequences for health issues (e.g., aspiration pneumonia or malnutrition) as well as for negative impact on their quality of life, it is on the highest importance of managing dysphagia timely and working closely together in a multidisciplinary team, who all are involved in the patients' care system. This chapter includes background information on epidemiology, pathophysiology, and symptomatology of swallowing disorders in PD. This is followed by a summary of the clinical course and health treats, adequate diagnostic procedures for early identification of dysphagia as well as effective treatment strategies. The conclusion provides recommendations for clinical practice routine.
吞咽困难在帕金森病（PD）中是一种非常常见且与生活质量、发病率和剩余寿命高度相关的症状，遗憾的是，在以患者为中心的护理方面，它普遍未得到充分诊断和重视。特别是在疾病早期，疾病与吞咽障碍之间的因果关系仍未被注意到，这可能是由于护理人员和医生无法察觉细微的吞咽问题以及帕金森病患者自身意识淡薄所致。为了防止患者出现健康问题（如吸入性肺炎或营养不良）的严重负面后果以及对其生活质量产生负面影响，及时管理吞咽困难并在多学科团队中密切合作至关重要，该团队所有成员都参与患者的护理体系。本章包括帕金森病吞咽障碍的流行病学、病理生理学和症状学的背景信息。随后是临床病程和健康威胁的总结、用于早期识别吞咽困难的适当诊断程序以及有效的治疗策略。结论部分提供了临床实践常规的建议。
