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一种用于帕金森病患者吞咽困难的新型吞咽补充剂。

A new swallowing supplement for dysphagia in patients with Parkinson's disease.

作者信息

Oh Eungseok, Jee Sungju, Kim Beom Keun, Lee Jung Seon, Cho Kanghee, Ahn Soyoung

机构信息

Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea.

Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea.

出版信息

Neurol Sci. 2021 May;42(5):1949-1958. doi: 10.1007/s10072-020-04730-w. Epub 2020 Sep 26.

Abstract

Dysphagia associated with Parkinson's disease (PD) affects the mortality and quality of life of patients with PD. Avoiding aspiration and maintaining swallowing ability are among the concerns regarding PD care. Therefore, we developed a swallowing supplement for easier swallowing and tolerability in patients with PD. Thirty patients with PD and 50 healthy controls were enrolled and their swallowing function measured using the videofluoroscopic swallowing study (VFSS) and several dysphagia scales. The Unified Parkinson's Disease Rating Scale motor scores, Hoehn and Yahr stage, and levodopa doses were evaluated in patients with PD. The VFSS and survey were used to assess the viscosity, color, taste, nutrition, safety, and tolerability of the swallowing supplement. The MMSE score, serum albumin, and hemoglobin levels, and oral conditions were worse in the PD group than in the control group. Compared with controls, patients with PD had significantly lower total and sub-item scores of the swallowing quality of life (swal-QoL). Using commercialized yogurt, the pharyngeal delay time (PDT) and the modified penetration aspiration scale were higher in the PD group than in the control group. The swallowing supplement significantly shortened the PDT and pharyngeal transit time (PTT). Moreover, compared with commercialized yogurt, it improved pharyngeal wall coating, PTT, and aspiration in the videofluoroscopic dysphagia subscales. The survey scores were above average to good in the "easy swallowing" and "pharyngeal residual sense" items and tolerable in the remaining 6 preference items. This swallowing supplement could prevent aspiration and dysphagia complications in patients with PD.

摘要

帕金森病(PD)相关的吞咽困难会影响PD患者的死亡率和生活质量。避免误吸和维持吞咽能力是PD护理的关注点。因此,我们开发了一种吞咽补充剂,以提高PD患者的吞咽便利性和耐受性。招募了30名PD患者和50名健康对照者,使用视频荧光吞咽造影检查(VFSS)和几种吞咽困难量表测量他们的吞咽功能。对PD患者评估统一帕金森病评定量表运动评分、Hoehn和Yahr分期以及左旋多巴剂量。使用VFSS和调查来评估吞咽补充剂的粘度、颜色、味道、营养、安全性和耐受性。PD组的简易精神状态检查表(MMSE)评分、血清白蛋白和血红蛋白水平以及口腔状况均比对照组差。与对照组相比,PD患者的吞咽生活质量(swal-QoL)总分及各子项得分显著更低。使用市售酸奶时,PD组的咽部延迟时间(PDT)和改良渗透误吸量表评分高于对照组。吞咽补充剂显著缩短了PDT和咽部通过时间(PTT)。此外,与市售酸奶相比,它在视频荧光吞咽困难子量表中改善了咽壁覆盖、PTT和误吸情况。在“易于吞咽”和“咽部残留感”项目中,调查评分高于平均水平至良好,在其余6个偏好项目中可接受。这种吞咽补充剂可以预防PD患者的误吸和吞咽困难并发症。

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