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24 个月或以下儿童行吞咽荧光透视检查前后的临床转归。

Clinical outcomes before and after videofluoroscopic swallow study in children 24 months of age or younger.

机构信息

Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS) Brasil.

Departamento de Saúde e Comunicação Humana, Faculdade de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS) Brasil.

出版信息

J Bras Pneumol. 2024 Mar 22;50(1):e20230290. doi: 10.36416/1806-3756/e20230290. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the combined impact of videofluoroscopic swallow study (VFSS) and therapeutic feeding and swallowing interventions on clinical outcomes in children with oropharyngeal dysphagia (OPD).

METHODS

This was an uncontrolled longitudinal analytical study in which OPD patients were evaluated before and after VFSS. Children ≤ 24 months of age diagnosed with OPD in a clinical setting and undergoing VFSS for investigation and management of OPD were included in the study. The study participants received therapeutic feeding and swallowing interventions after having undergone VFSS, being followed at an outpatient clinic for pediatric dysphagia in order to monitor feeding and swallowing difficulties. Respiratory and feeding outcomes were compared before and after VFSS.

RESULTS

Penetration/aspiration events were observed in 61% of the VFSSs (n = 72), and therapeutic feeding and swallowing interventions were recommended for 97% of the study participants. After the VFSS, there was a reduction in the odds of receiving antibiotic therapy (OR = 0.007) and in the duration of antibiotic therapy (p = 0.014), as well as in the odds of being admitted to hospital (p = 0.024) and in the length of hospital stay (p = 0.025). A combination of oral and enteral feeding became more common than oral or enteral feeding alone (p = 0.002).

CONCLUSIONS

A high proportion of participants exhibited penetration/aspiration on VFSS. Therapeutic feeding and swallowing interventions following a VFSS appear to be associated with reduced respiratory morbidity in this population.

摘要

目的

评估吞咽造影检查(VFSS)和治疗性喂养及吞咽干预对有口咽性吞咽障碍(OPD)的儿童的临床结局的综合影响。

方法

这是一项无对照的纵向分析研究,其中对 VFSS 前后的 OPD 患者进行了评估。在临床环境中诊断为 OPD 的年龄≤24 个月的儿童,以及因 OPD 接受 VFSS 检查和治疗的儿童,被纳入该研究。研究参与者在接受 VFSS 后接受了治疗性喂养和吞咽干预,在儿科吞咽障碍门诊进行随访,以监测喂养和吞咽困难。比较 VFSS 前后的呼吸和喂养结局。

结果

VFSS 中观察到 61%(n=72)有渗透/吸入事件,97%的研究参与者被推荐进行治疗性喂养和吞咽干预。VFSS 后,接受抗生素治疗的可能性降低(OR=0.007),抗生素治疗的持续时间缩短(p=0.014),住院的可能性降低(p=0.024),住院时间缩短(p=0.025)。口服和肠内喂养的联合使用比单独使用口服或肠内喂养更为常见(p=0.002)。

结论

相当一部分参与者在 VFSS 上显示出渗透/吸入。VFSS 后进行治疗性喂养和吞咽干预似乎与该人群的呼吸道发病率降低有关。

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