Servicio de Gastroenterología y Nutrición Pediátrica, División de Pediatría, Nuevo Hospital Civil de Guadalajara «Dr. Juan I. Menchaca», Guadalajara, Jalisco, Mexico.
Subdirección de Enseñanza e Investigación, Nuevo Hospital Civil de Guadalajara «Dr. Juan I. Menchaca», Guadalajara, Jalisco, Mexico; Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
Rev Gastroenterol Mex (Engl Ed). 2022 Jan-Mar;87(1):44-51. doi: 10.1016/j.rgmxen.2020.09.004. Epub 2021 Oct 9.
Oropharyngeal dysphagia (OD) occurs in children with cerebral palsy. It is important to investigate its relationship with some variables, and the objective of this study was to identify factors associated with OD.
Case-control study in patients with cerebral palsy from 8months to 15years of age, from November 2018 to November 2019, approved by the Ethics Committee. The diagnosis of OD was made by videofluoroscopy when there was nasopharyngeal reflux, stagnation in the vallecular sinuses, in the piriformis sinuses, penetration, and aspiration. The independent variables were type of cerebral palsy, gross motor impairment classified into five levels, nutritional status and comorbidities. One case with OD was included and the next one without alterations in videofluoroscopy was control. The variables were compared with Chi square and Student's t. The association was measured with odds ratio. The confidence interval was 95%.
Thirty patients with OD and 30without OD were studied. Sex, age, birth weight, and gestational age had a similar distribution in the two groups. From the data perceived by the mothers at the time of feeding, the greater frequency of the difficulty in the transfer of the food bolus in the group with OD showed a statistically significant difference (P<.001) and of the studied factors, the levelV of the gross motor involvement was associated with a higher frequency of OD.
OD was associated with level V of gross motor involvement.
脑性瘫痪患儿可发生口咽性吞咽困难（OD）。重要的是要研究其与某些变量的关系，本研究的目的是确定与 OD 相关的因素。
这是一项 2018 年 11 月至 2019 年 11 月间进行的脑瘫患儿病例对照研究，研究方案已经伦理委员会批准。当存在鼻咽反流、 vallecular 窦、梨状窦停滞、渗透和吸入时，通过视频透视来诊断 OD。独立变量包括脑瘫类型、分为 5 个级别的粗大运动损伤、营养状况和合并症。每个有 OD 的病例都与一个无视频透视改变的病例相匹配作为对照。使用卡方检验和 Student's t 检验比较变量。使用比值比来衡量关联，置信区间为 95%。
研究共纳入 30 例 OD 患儿和 30 例无 OD 患儿。两组患儿的性别、年龄、出生体重和胎龄分布相似。从母亲在喂养时感知到的数据来看，在有 OD 的组中，食物团转移困难的频率更高，具有统计学显著性差异（P<.001）。在研究的因素中，粗大运动受累程度 V 级与 OD 发生的频率更高相关。
OD 与粗大运动受累程度 V 级相关。
