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改良饮食、吞咽训练及神经肌肉电刺激对老年患者口咽吞咽困难严重程度的影响

Impact of Modified Diet, Swallowing Exercises, and Neuromuscular Electrostimulation on Severity of Oropharyngeal Dysphagia of Geriatric Patients.

作者信息

Rugaitienė Margarita, Lesauskaitė Vita, Ulozienė Ingrida, Kalinauskaitė Gerda, Juška Marius, Damulevičienė Gytė

机构信息

Clinical Department of Geriatrics, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2024 Nov 23;60(12):1927. doi: 10.3390/medicina60121927.

Abstract

: Oropharyngeal dysphagia is a common swallowing disorder, characterized by difficulties in moving food and liquids from the mouth to the esophagus; it is particularly prevalent among older adults with neurological conditions. This study aimed to evaluate the effectiveness of a short-term complex treatment protocol combining dietary modifications, swallowing exercises, and transcutaneous neuromuscular electrostimulation in reducing the oropharyngeal dysphagia severity and aspiration risk among geriatric patients. : A total of 64 participants aged 60 and older, with oropharyngeal dysphagia, at LSMU Kaunas Hospital between May 2021 and April 2023, were included in the study after excluding those with significant comorbidities. Diagnostic assessments included the water swallow test and Fiberoptic Endoscopic Evaluation of Swallowing, conducted before and after treatment. : The results indicated a statistically significant reduction in the severity of oropharyngeal dysphagia, with 18.8% of patients showing improvements from moderate to mild dysphagia and 33.3% from severe to moderate. Additionally, the median PAS score was four points (IQR 3-6) before treatment and significantly decreased to three points (IQR 2-4) after treatment ( < 0.001). : These findings suggest that even a short-term multidisciplinary approach that lasts 10 days can effectively alleviate the symptoms of oropharyngeal dysphagia, enhance patient safety, and improve swallowing among geriatric patients suffering from this condition.

摘要

口咽吞咽困难是一种常见的吞咽障碍,其特征是将食物和液体从口腔输送到食管存在困难;在患有神经系统疾病的老年人中尤为普遍。本研究旨在评估一种短期综合治疗方案的有效性,该方案结合饮食调整、吞咽练习和经皮神经肌肉电刺激,以降低老年患者的口咽吞咽困难严重程度和误吸风险。

2021年5月至2023年4月期间,在考纳斯大学医学中心医院,共有64名60岁及以上患有口咽吞咽困难的参与者在排除患有严重合并症的患者后被纳入研究。诊断评估包括治疗前后进行的水吞咽试验和吞咽功能纤维内镜评估。

结果表明,口咽吞咽困难的严重程度在统计学上有显著降低,18.8%的患者从中度吞咽困难改善为轻度,33.3%的患者从重度改善为中度。此外,治疗前的中位渗透误吸量表(PAS)评分为4分(四分位间距3 - 6),治疗后显著降至3分(四分位间距2 - 4)(P < 0.001)。

这些发现表明,即使是为期10天的短期多学科方法,也可以有效缓解口咽吞咽困难的症状,提高患者安全性,并改善患有这种疾病的老年患者的吞咽功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3148/11677869/07cf2948c5a8/medicina-60-01927-g001.jpg

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