Raciti Loredana, Raciti Gianfranco, Pulejo Grazia, Conti-Nibali Valeria, Calabrò Rocco Salvatore
GCA-Centro Spoke AO Cannizzaro, Catania, IRCCS Centro Neurolesi Bonino-Pulejo, 95122 Messina, Italy.
Neurorehabilitation Unit, IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy.
Medicines (Basel). 2022 Feb 21;9(2):16. doi: 10.3390/medicines9020016.
Neurogenic dysphagia is a difficulty in swallowing food caused by disease or impairment of the nervous system, including stroke and traumatic brain injury. The most clinically apparent complication of neurogenic dysphagia is pulmonary aspiration, which may manifest itself acutely as choking or coughing, respiratory distress, wheezing, gasping or gurgling, and tachycardia. However, chronic symptoms, including weight loss, production of excessive oral secretions and aspiration pneumonia, may be also present, especially in patients with a disorder of consciousness (DOC). Usually, patients with dysphagia after the acute phase need to be treated with enteral nutrition using a feeding tube. This avoids patient malnutrition and supports the rehabilitation program. This narrative review aims to investigate dysphagia and its complications and management in patients with DOC. Clinical indications and practical advice on how to assess and treat this complex problem are also provided.
神经源性吞咽困难是由神经系统疾病或损伤（包括中风和创伤性脑损伤）引起的吞咽食物困难。神经源性吞咽困难最明显的临床并发症是肺误吸，其可能急性表现为呛咳、咳嗽、呼吸窘迫、喘息、气喘或咕噜声，以及心动过速。然而，慢性症状，包括体重减轻、口腔分泌物过多和吸入性肺炎，也可能出现，尤其是在意识障碍（DOC）患者中。通常，急性期后有吞咽困难的患者需要通过饲管进行肠内营养治疗。这可避免患者营养不良并支持康复计划。本叙述性综述旨在研究DOC患者的吞咽困难及其并发症和管理。还提供了关于如何评估和治疗这一复杂问题的临床指征和实用建议。
