Yang Seoyon, Park Jin-Woo, Min Kyunghoon, Lee Yoon Se, Song Young-Jin, Choi Seong Hee, Kim Doo Young, Lee Seung Hak, Yang Hee Seung, Cha Wonjae, Kim Ji Won, Oh Byung-Mo, Seo Han Gil, Kim Min-Wook, Woo Hee-Soon, Park Sung-Jong, Jee Sungju, Oh Ju Sun, Park Ki Deok, Jin Young Ju, Han Sungjun, Yoo DooHan, Kim Bo Hae, Lee Hyun Haeng, Kim Yeo Hyung, Kang Min-Gu, Chung Eun-Jae, Kim Bo Ryun, Kim Tae-Woo, Ko Eun Jae, Park Young Min, Park Hanaro, Kim Min-Su, Seok Jungirl, Im Sun, Ko Sung-Hwa, Lim Seong Hoon, Jung Kee Wook, Lee Tae Hee, Hong Bo Young, Kim Woojeong, Shin Weon-Sun, Lee Young Chan, Park Sung Joon, Lim Jeonghyun, Kim Youngkook, Lee Jung Hwan, Ahn Kang-Min, Paeng Jun-Young, Park JeongYun, Song Young Ae, Seo Kyung Cheon, Ryu Chang Hwan, Cho Jae-Keun, Lee Jee-Ho, Choi Kyoung Hyo
Department of Rehabilitation Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Goyang, Korea.
Ann Rehabil Med. 2023 Jul;47(Suppl 1):S1-S26. doi: 10.5535/arm.23069. Epub 2023 Jul 30.
Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one's physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia.
Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology.
Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended.
This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.
吞咽困难是一种常见的临床病症,其特征为吞咽困难。它可细分为口咽性吞咽困难(指口腔和咽部的问题)和食管性吞咽困难(指食管体部和食管胃交界处的问题)。随着吞咽困难严重程度的增加,它会对人的身体健康和生活质量产生重大负面影响。因此,对吞咽困难进行恰当的评估和管理对于改善吞咽功能及预防并发症至关重要。于是制定了一项指南,为吞咽困难患者的评估和管理提供基于证据的建议。
针对吞咽困难提出了19个关键问题。这些问题涉及与吞咽困难相关问题的各个方面,包括评估、管理和并发症。使用PubMed、Embase、Cochrane图书馆以及韩国Med的一个国内数据库,对相关文章进行文献检索,直至2021年4月。根据推荐评估、制定和评价方法确定证据水平和推荐等级。
建议对吞咽困难的存在进行早期筛查和视频荧光吞咽评估。治疗方法,如舌和咽部肌肉强化训练以及吞咽治疗时的神经肌肉电刺激,对改善吞咽困难患者的吞咽功能和生活质量有效。还推荐了营养干预和口腔护理计划。
本指南提出了对口咽性吞咽困难患者评估和管理的建议,包括康复策略。