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使用荧光透视吞咽研究评估吸入性肺炎患者的吞咽障碍发生率和严重程度。

Prevalence and Severity of Dysphagia Using Videofluoroscopic Swallowing Study in Patients with Aspiration Pneumonia.

机构信息

Department of Rehabilitation Medicine, Rehabilitation Hospital, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Republic of Korea.

Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Republic of Korea.

出版信息

Lung. 2021 Feb;199(1):55-61. doi: 10.1007/s00408-020-00413-7. Epub 2021 Jan 17.

Abstract

INTRODUCTION

The purpose of this study was to identify the prevalence and severity of dysphagia in patients diagnosed with aspiration pneumonia, with and without neurologic disorders.

METHODS

We retrospectively reviewed the medical records of inpatients with aspiration pneumonia who underwent a videofluoroscopic swallowing study (VFSS) for evaluation of dysphagia. Patients were divided into two groups based on the presence or absence of neurologic disorders. The prevalence and severity of aspiration and pharyngeal residue due to dysphagia were assessed using the penetration-aspiration scale (PAS) and pharyngeal residue grade (PRG).

RESULTS

A total of 784 patients were enrolled; of these, 58.7% were males and the mean age was 76.12 ± 6.69. Penetration-aspiration-related dysphagia (PAS scores 3-8) was seen in 56.5% of all subjects, and 32.5% showed silent aspiration (PAS 8). Pharyngeal residue-related dysphagia (PRG scores 2-3) was seen in 65.2% of all patients, and the PAS and PRG were positively correlated. On dividing the subjects into two groups based on the presence of neurologic disorders, there was no significant difference in prevalence of the dysphagia between groups (PAS: p = 0.641; PRG: p = 0.872) with the proportion of silent aspiration (p = 0.720).

CONCLUSION

In patients hospitalized for aspiration pneumonia, there was a high prevalence of dysphagia. There were no differences in the prevalence and severity of dysphagia in patients with aspiration pneumonia based on the presence or absence of a neurologic disorder. Therefore, diagnostic evaluation of dysphagia is necessary regardless of the presence of neurologic disorders.

摘要

简介

本研究旨在确定诊断为吸入性肺炎的患者中伴有和不伴有神经障碍的吞咽困难的患病率和严重程度。

方法

我们回顾性分析了因吞咽困难而行视频透视吞咽检查(VFSS)评估的吸入性肺炎住院患者的病历。根据是否存在神经障碍将患者分为两组。使用渗透-误吸量表(PAS)和咽部残留物分级(PRG)评估因吞咽困难导致的误吸和咽部残留物的患病率和严重程度。

结果

共纳入 784 例患者;其中,男性占 58.7%,平均年龄为 76.12±6.69 岁。所有受试者中有 56.5%存在与渗透-误吸相关的吞咽困难(PAS 评分 3-8),32.5%存在无声误吸(PAS 8)。所有患者中有 65.2%存在与咽部残留物相关的吞咽困难(PRG 评分 2-3),且 PAS 和 PRG 呈正相关。根据是否存在神经障碍将受试者分为两组,两组之间的吞咽困难患病率无显著差异(PAS:p=0.641;PRG:p=0.872),无声误吸的比例也无显著差异(p=0.720)。

结论

因吸入性肺炎住院的患者吞咽困难的患病率较高。患有吸入性肺炎的患者中,无论是否存在神经障碍,吞咽困难的患病率和严重程度无差异。因此,无论是否存在神经障碍,都有必要对吞咽困难进行诊断评估。

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