Lazarus C, Logemann J A
Arch Phys Med Rehabil. 1987 Feb;68(2):79-84.
Fifty-three closed head trauma patients with dysphagia were examined videofluorographically to determine the specific nature of their swallowing disorder. Eighty-one percent of the patients exhibited a delayed or absent swallowing reflex while approximately 50% of the patients suffered from reduced tongue control, and 33% had reduced peristalsis. Laryngeal disorders and cricopharyngeal dysfunction occurred in a small number of patients. The average head trauma patient exhibited more than one swallowing motility problem. Twenty patients aspirated, with delayed or absent swallowing reflex as the most common etiology for the aspiration. Many of these patients did not produce a reflexive cough during or after they had aspirated material into their airway. For this reason, and since the pharyngeal stage of the swallow is extremely difficult to assess with presently available bedside techniques, videofluorographic evaluation becomes an invaluable tool for identification of the precise nature of the swallowing disturbance, the presence of aspiration, and the etiology of the aspiration.
对53名患有吞咽困难的闭合性颅脑损伤患者进行了电视透视检查，以确定其吞咽障碍的具体性质。81%的患者出现吞咽反射延迟或缺失，约50%的患者存在舌控制能力下降，33%的患者蠕动减弱。少数患者出现喉部疾病和环咽肌功能障碍。普通颅脑损伤患者表现出不止一种吞咽运动问题。20名患者发生误吸，吞咽反射延迟或缺失是误吸最常见的病因。这些患者中的许多人在将物质误吸入气道期间或之后没有产生反射性咳嗽。因此，由于目前可用的床边技术极难评估吞咽的咽部阶段，电视透视评估成为确定吞咽障碍的确切性质、误吸的存在以及误吸病因的宝贵工具。
