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[老年人吞咽:生理变化、吞咽困难、诊断与治疗]

[Swallowing in the elderly : Physiological changes, dysphagia, diagnostics and treatment].

作者信息

Muhle P, Suntrup-Krueger S, Wirth R, Warnecke T, Dziewas R

机构信息

Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.

Institut für Biomagnetismus und Biosignalanalyse, Universitätsklinikum Münster, Münster, Deutschland.

出版信息

Z Gerontol Geriatr. 2019 May;52(3):279-289. doi: 10.1007/s00391-019-01540-4. Epub 2019 Apr 9.

Abstract

Increasing age leads to a number of physiological as well as disease-related pathological changes that among others also affect structures involved in swallowing. These changes not only increase the risk of developing dysphagia but as a result can lead to pneumonia, malnutrition, exsiccosis, a relevant impairment of the quality of life and increased mortality. To evaluate the nature and extent of dysphagia, clinical swallowing tests as well as instrumental approaches, such as the endoscopic evaluation of swallowing are available. Depending on the findings from these examinations, the underlying disease and estimation of the individual patient prognosis, several treatment approaches ranging from diet adaptation, logopedic exercises and compensatory maneuvers up to tube feeding are available. The optimal treatment requires close cooperation of all disciplines involved.

摘要

年龄增长会导致许多生理以及与疾病相关的病理变化,其中包括影响吞咽相关结构的变化。这些变化不仅会增加吞咽困难的发生风险,还可能导致肺炎、营养不良、脱水、生活质量显著受损以及死亡率上升。为了评估吞咽困难的性质和程度,可以采用临床吞咽测试以及仪器检查方法,如吞咽内镜评估。根据这些检查结果、潜在疾病以及对个体患者预后的估计,有多种治疗方法可供选择,从饮食调整、语言治疗练习和代偿动作到管饲。最佳治疗需要所有相关学科密切合作。

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