每日吞咽频率与重症脑瘫患者肺炎的关系。
Relationship between daily swallowing frequency and pneumonia in patients with severe cerebral palsy.
机构信息
Division of Oral and Facial Disorders, Osaka University Dental Hospital, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Division of Functional Oral Neuroscience, Graduate School of Dentistry, Osaka University, 1-8, Yamadaoka, Suita, Osaka, 565-0871, Japan.
出版信息
BMC Pediatr. 2022 Aug 13;22(1):485. doi: 10.1186/s12887-022-03547-0.
BACKGROUND
Aspiration pneumonia is a major complication that occurs in patients with severe cerebral palsy and is associated with their survival prognosis, necessitating appropriate assessment and response. We focused on swallowing frequency as an index of daily swallowing function due to the difficulty in evaluating the risk of pneumonia. The swallowing motion protects the airway by safely directing the food, saliva, and secretions accumulated in the pharynx into the esophagus to prevent aspiration and entry into the trachea. Thus, swallowing frequency may be correlated with the incidence of pneumonia. In this study, we aimed to investigate the relationship between swallowing frequency and history of pneumonia in patients with severe cerebral palsy.
METHODS
Fifty-seven patients with cerebral palsy were included in this study. Swallowing frequency was measured three times for each patient on separate days, and the reproducibility was examined by calculating the intraclass correlation coefficient. Further, the relationship between swallowing frequency and history of pneumonia was investigated using multivariate logistic regression analysis.
RESULTS
While swallowing frequency differed between participants, it was constant within individuals (intraclass correlation coefficient: 0.941). Furthermore, the swallowing frequencies per hour were 12.2 ± 12.2 and 27.0 ± 20.4 in the patient groups with and without a history of pneumonia, respectively (P < 0.001). Swallowing frequency (odds ratio: 10.489, 95% confidence interval: 2.706-40.663, P = 0.001) was significantly associated with the incidence of pneumonia in the previous year.
CONCLUSIONS
Swallowing frequency could be used as an index for assessing the risk of dysphagia and pneumonia in patients with severe cerebral palsy.
背景
吸入性肺炎是严重脑瘫患者的主要并发症之一，与患者的生存预后相关，因此需要进行适当的评估和处理。由于难以评估肺炎的风险，我们关注吞咽频率作为日常吞咽功能的指标。吞咽运动通过将积聚在咽部的食物、唾液和分泌物安全地引导到食管中，从而保护气道，防止吸入和进入气管。因此，吞咽频率可能与肺炎的发生率相关。在本研究中，我们旨在探讨严重脑瘫患者吞咽频率与肺炎史之间的关系。
方法
本研究纳入了 57 例脑瘫患者。对每位患者在不同的日子进行三次吞咽频率测量，并通过计算组内相关系数来检验重复性。进一步通过多变量逻辑回归分析探讨吞咽频率与肺炎史之间的关系。
结果
虽然参与者的吞咽频率不同，但个体内的吞咽频率是恒定的（组内相关系数：0.941）。此外，有肺炎史和无肺炎史的患者组每小时的吞咽频率分别为 12.2±12.2 和 27.0±20.4（P<0.001）。吞咽频率（比值比：10.489，95%置信区间：2.706-40.663，P=0.001）与前一年肺炎的发生率显著相关。
结论
吞咽频率可作为评估严重脑瘫患者吞咽困难和肺炎风险的指标。
Zotero 插件