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100 例犬气道穿透和吸入相关的发生率、临床症状和视频荧光吞咽研究异常。

Incidence, clinical signs, and videofluoroscopic swallow study abnormalities associated with airway penetration and aspiration in 100 dogs.

机构信息

Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA.

Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, Missouri, USA.

出版信息

J Vet Intern Med. 2022 Nov;36(6):2149-2159. doi: 10.1111/jvim.16553. Epub 2022 Oct 19.

Abstract

BACKGROUND

Videofluoroscopic swallow studies (VFSS) utilizing penetration-aspiration (P-A) scoring assesses airway protection in people. On VFSS, penetration (ingesta or secretions immediately cranial to the vocal folds) and aspiration (material caudal to the vocal folds) are associated with increased risk of lung injury in people. Penetration-aspiration (P-A) scoring has been validated in animal models, but the incidence of P-A, clinical signs (CS), and dysphagic disorders associated with P-A in dogs are unknown.

OBJECTIVES

Using VFSS, identify the incidence of P-A, compare CS between dogs with and without P-A, and identify predisposing dysphagic abnormalities for P-A.

ANIMALS

One hundred client-owned dogs.

METHODS

Sequential VFSS and associated medical records from dogs presenting to the veterinary teaching hospitals at Auburn University (n = 53) and the University of Missouri (n = 47) were retrospectively reviewed. Statistical comparisons were made using Mann-Whitney tests, one-way analysis of variance (ANOVA) on ranks, multiple linear regression, and Spearman rank order correlation (P < .05).

RESULTS

On VFSS, the incidence of pathologic P-A was 39%. No significant differences in CS were found between dogs with or without P-A (P > .05), with 14/39 dogs with P-A presenting without respiratory CS. Pharyngeal (P < .001) and esophageal (P = .009), but not oral-preparatory (P = .2) dysphagia was more common with P-A. Pharyngeal weakness (P < .001) and esophago-oropharyngeal reflux (EOR; P = .05) were independent predictors of P-A and were moderately and weakly positively correlated with P-A score respectively (P < .001, r = 0.489; P = .04, r = 0.201).

CONCLUSIONS

Penetration-aspiration occurs in dogs in the absence of respiratory CS (i.e., occult P-A). Dogs with pharyngeal weakness and EOR should be considered at risk for P-A.

摘要

背景

利用渗透-吸入(P-A)评分的透视吞咽研究(VFSS)评估了人的气道保护情况。在 VFSS 中,渗透(摄入物或分泌物立即位于声带上方)和吸入(物质位于声带下方)与肺部损伤风险增加有关。渗透-吸入(P-A)评分已在动物模型中得到验证,但在狗中,P-A 的发生率、临床症状(CS)以及与 P-A 相关的吞咽障碍尚不清楚。

目的

使用 VFSS 确定 P-A 的发生率,比较有和无 P-A 的狗之间的 CS,并确定 P-A 易患的吞咽异常。

动物

100 只客户拥有的狗。

方法

回顾性分析了来自奥本大学兽医教学医院(n=53)和密苏里大学兽医教学医院(n=47)的连续 VFSS 及其相关病历。使用曼-惠特尼检验、秩的单向方差分析(ANOVA)、多元线性回归和斯皮尔曼等级相关进行统计比较(P<.05)。

结果

在 VFSS 上,病理性 P-A 的发生率为 39%。有和无 P-A 的狗之间的 CS 无显著差异(P>.05),有 14/39 例 P-A 的狗没有出现呼吸 CS。与 P-A 相关的更常见的是咽部(P<.001)和食管(P=.009),但不是口腔准备(P=.2)吞咽困难。咽部无力(P<.001)和食管-口咽反流(EOR;P=.05)是 P-A 的独立预测因素,与 P-A 评分呈中度和弱正相关(P<.001,r=0.489;P=.04,r=0.201)。

结论

狗在没有呼吸 CS 的情况下发生渗透-吸入(即隐匿性 P-A)。咽部无力和 EOR 的狗应被视为 P-A 的高危人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5de4/9708423/64ac9b528c56/JVIM-36-2149-g003.jpg

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