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评估有食管闭锁-气管食管瘘相关喂养-吞咽困难患儿的照料者的担忧。

Assessment of the Concerns of Caregivers of Children with Repaired Esophageal Atresia-Tracheoesophageal Fistula Related to Feeding-Swallowing Difficulties.

机构信息

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, 06100, Ankara, Turkey.

Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

出版信息

Dysphagia. 2020 Jun;35(3):438-442. doi: 10.1007/s00455-019-10046-5. Epub 2019 Aug 13.

Abstract

The study aimed to assess concerns of caregivers of children with EA-TEF related to feeding-swallowing difficulties, compare the concerns according to type of atresia and repair time, and investigate its relationship with time to start oral feeding. Caregivers accompanying 64 children with EA-TEF were included. Age, sex, type of atresia, repair time, and time to start oral feeding were noted. Parents completed the Turkish version of the Feeding/Swallowing Impact Survey (T-FS-IS) to assess the concerns of caregivers related to feeding-swallowing difficulties. The T-FS-IS has three subscales including daily activities, worry, and feeding difficulties. The median age of patients was 3 (min = 1, max = 12) years, of which 57.8% were male. 43.8% of cases were isolated-EA, and 56.3% were EA-distal TEF. 57.8% of cases received early repair, and 42.2% had delayed repair. The median time to start oral feeding was 4 weeks (min = 1, max = 128). The mean scores of daily activities, worry, feeding difficulties, and total score from the T-FS-IS were 2.43 ± 1.18, 2.73 ± 1.28, 2.10 ± 0.97, and 2.44 ± 1.09, respectively. Caregivers of children with isolated-EA reported more problems in total score and all subscales of the T-FS-IS than EA-distal TEF (p < 0.01). Caregivers of children who received delayed repair reported more problems in total score and all subscales of the T-FS-IS than children with early repair (p < 0.05). Moderate to strong correlations were found between the T-FS-IS and time to start oral feeding (p < 0.01, r = 0.55-0.65). This study suggests that caregivers of children with isolated-EA and/or delayed repair and/or delay in oral intake may have higher concerns related to feeding-swallowing difficulties.

摘要

本研究旨在评估 EA-TEF 相关喂养-吞咽困难患儿的照顾者的担忧,根据不同的闭锁类型和修复时间比较这些担忧,并探讨其与开始口服喂养的时间的关系。共纳入 64 例 EA-TEF 患儿的照顾者。记录年龄、性别、闭锁类型、修复时间和开始口服喂养的时间。父母使用土耳其版喂养/吞咽影响调查问卷(T-FS-IS)评估与喂养-吞咽困难相关的照顾者的担忧。T-FS-IS 有三个分量表,包括日常生活活动、担忧和喂养困难。患者的中位年龄为 3 岁(最小=1 岁,最大=12 岁),其中 57.8%为男性。43.8%的病例为单纯 EA,56.3%为 EA 远端 TEF。57.8%的病例行早期修复,42.2%行延迟修复。开始口服喂养的中位时间为 4 周(最小=1 周,最大=128 周)。T-FS-IS 的日常生活活动、担忧、喂养困难和总分的平均得分分别为 2.43±1.18、2.73±1.28、2.10±0.97 和 2.44±1.09。单纯 EA 的患儿照顾者在总分和 T-FS-IS 的所有分量表上的得分均高于 EA 远端 TEF(p<0.01)。行延迟修复的患儿照顾者在总分和 T-FS-IS 的所有分量表上的得分均高于行早期修复的患儿(p<0.05)。T-FS-IS 与开始口服喂养的时间之间存在中度至强相关性(p<0.01,r=0.55-0.65)。本研究表明,孤立性 EA 和/或延迟修复和/或口服摄入延迟的患儿的照顾者可能对喂养-吞咽困难有更高的担忧。

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