Division of Neonatology, Department of Pediatrics, University Hospital Son Espases, Palma de Mallorca, Spain.
Division of Pediatric Respiratory Medicine, Department of Pediatrics, University Hospital Son Espases, Palma de Mallorca, Spain.
Pediatr Pulmonol. 2018 Apr;53(4):437-442. doi: 10.1002/ppul.23946. Epub 2018 Jan 22.
Swallowing disorders which lead to aspiration are common in premature infants with a postmenstrual age (PMA) of >36 weeks. Aspiration is often silent and the unique symptom is desaturation during feeding. The aim of this study was 1) to determine the number of prematures with desaturations during feeding due to aspiration, using Fiberoptic Endoscopic Evaluation of Swallowing (FEES); 2) to relate clinical factors and FEES findings to aspiration; and 3) to describe type and efficacy of suggested treatments.
A retrospective review of 62 ex-premature babies with a median PMA of 40 weeks which underwent FEES due to persistent feeding desaturations. Aspiration was related to other FEES findings and to clinical and demographic data. The efficacy of the treatment was evaluated during the FEES and by comparing recorded desaturations during feeding 7 days before and after FEES.
A total of 44 (71%) infants were diagnosed with aspiration and/or penetration. No relation was found to demographic or clinical data. The accumulation of saliva and residues post-swallowing were related to aspiration (P < 0.01). In 77.3% of the infants, use of a thickener seemed to reduce aspiration during FEES and was suggested as a treatment. 13.6% of infants received anti-reflux treatment after FEES and 9.1% required gastrostomy.
Aspiration is very frequent in premature infants who present desaturations during feeding and FEES is a useful method for diagnosing and suggesting treatments.
胎龄（PMA）超过 36 周的早产儿常有吞咽障碍导致误吸，误吸常无症状，唯一的症状是喂养时脱氧。本研究的目的是：1）通过纤维内镜吞咽功能检查（FEES）确定因误吸导致喂养时脱氧的早产儿数量；2）将临床因素和 FEES 结果与误吸相关联；3）描述建议治疗的类型和效果。
回顾性分析了 62 例胎龄中位数为 40 周的既往早产儿，因持续喂养脱氧而行 FEES。将误吸与其他 FEES 结果以及临床和人口统计学数据相关联。FEES 时以及 FEES 前后 7 天的喂养时脱氧记录评估治疗效果。
共有 44 例（71%）婴儿被诊断为误吸和/或误咽。未发现与人口统计学或临床数据有关。吞咽后唾液和残留物的积聚与误吸有关（P < 0.01）。在 77.3%的婴儿中，使用增稠剂似乎能减少 FEES 时的误吸，并被建议作为一种治疗方法。FEES 后，13.6%的婴儿接受了抗反流治疗，9.1%的婴儿需要胃造口术。
在出现喂养时脱氧的早产儿中，误吸非常常见，FEES 是一种诊断和建议治疗的有用方法。
