儿科吞咽障碍诊所的观察结果：有发生吸入性肺炎风险的儿童的特征。
Observations from a pediatric dysphagia clinic: Characteristics of children at risk of aspiration pneumonia.
机构信息
Dysphagia Services, Department of Head and Neck Surgery, Amrita Institute of Medical Sciences and Research Center, Kochi, Kerala, India.
出版信息
Laryngoscope. 2019 Nov;129(11):2614-2618. doi: 10.1002/lary.27654. Epub 2018 Dec 24.
OBJECTIVES
The clinical variables that are predictive of aspiration pneumonia are not clear in the pediatric population. This study was conducted in order to identify the demographic, clinical, and radiological risk factors for the development of aspiration pneumonia in children referred to the dysphagia clinic.
METHODS
A retrospective analysis of medical records of 88 children referred to the dysphagia clinic who had undergone videofluroscopic swallow study (VFSS).
RESULTS
Oropharyngeal dysphagia was found in 61.3% (54 of 88). Incidence of aspiration pneumonia was 39.8% (35 of 88).
CONCLUSION
Respiratory symptoms such as cough, choking, excessive secretions, and pharyngeal dysmotility other than aspiration in VFSS were not predictors of pneumonia. Infants and children with laryngotracheal anomalies, demonstrable aspiration in VFSS, and major cardiac illness are at risk of presenting with aspiration pneumonia. Whether gastroesophageal reflux disease (GERD) or esophageal dysmotility are causative of aspiration in the rest of the population needs to be investigated by future prospective studies.
LEVEL OF EVIDENCE
3b. Laryngoscope, 129:2614-2618, 2019.
目的
对于儿科人群，目前尚不清楚哪些临床变量可预测吸入性肺炎。本研究旨在确定因吞咽困难就诊于吞咽障碍门诊的儿童发生吸入性肺炎的人口统计学、临床和影像学危险因素。
方法
对 88 例行视频荧光透视吞咽研究（VFSS）的吞咽障碍门诊就诊儿童的病历进行回顾性分析。
结果
61.3%（88 例中有 54 例）存在口咽性吞咽困难。吸入性肺炎的发生率为 39.8%（88 例中有 35 例）。
结论
VFSS 中除吸入以外的呼吸道症状，如咳嗽、呛咳、分泌物过多和咽动力障碍，并非肺炎的预测因素。存在喉气管异常、VFSS 中可明确显示吸入、以及存在严重心脏疾病的婴儿和儿童有发生吸入性肺炎的风险。胃食管反流病（GERD）或食管动力障碍是否为其余人群中吸入的原因，需要未来前瞻性研究进行调查。
证据等级
3b.喉镜，129:2614-2618,2019.
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