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容量-黏度吞咽测试以促进脑出血后吞咽困难的个体化饮食调整。

Volume-viscosity swallow test to facilitate individualized dietary modifications for dysphagia following intracerebral hemorrhage.

作者信息

Chan Roger W, Fu Shuiqin, Zhang Yue, Shi Lei

机构信息

Geriatric Care Research Center, Xiamen Medical College, Xiamen, Fujian, 361023, China.

Department of Surgery, Second Affiliated Hospital, Xiamen Medical College, Xiamen, Fujian, 361021, China.

出版信息

Eur Arch Otorhinolaryngol. 2025 Jan 25. doi: 10.1007/s00405-025-09242-x.

DOI:10.1007/s00405-025-09242-x
PMID:39863820
Abstract

PURPOSE

This study examined the effects of individualized dietary modifications based on the volume-viscosity swallow test (V-VST) on functional oral intake, incidence of pneumonia, and swallowing-related quality of life in individuals with intracerebral hemorrhage.

METHODS

One hundred and seven participants with signs of dysphagia in the acute and early subacute phases of stroke following intracerebral hemorrhage were randomly assigned into an experimental group for individualized dietary modifications based on V-VST plus routine standard care (n = 53), and a control group for routine care alone (n = 54). Incidence of pneumonia, functional oral intake scale (FOIS) ratings and Eating Assessment Tool (EAT-10) scores before and after intervention were evaluated.

RESULTS

A significantly lower incidence of pneumonia was found in the experimental group than in the control group (p < 0.05). Significant group differences were found in functional oral intake and in quality of life, with significantly higher FOIS ratings and significantly lower EAT-10 scores in the experimental group post-intervention (p < 0.001).

CONCLUSION

These findings suggested that despite being a noninstrumental screening tool, V-VST could facilitate individualized dietary modifications and could be an effective clinical option for reducing the risk of pneumonia, improving functional oral intake and enhancing quality of life in individuals with dysphagia following intracerebral hemorrhage. Future studies should explore how dietary modifications could be more precisely implemented based on the International Dysphagia Diet Standardization Initiative framework.

摘要

目的

本研究探讨基于容量-黏度吞咽测试(V-VST)的个体化饮食调整对脑出血患者功能性经口摄入量、肺炎发生率及吞咽相关生活质量的影响。

方法

107名在脑出血后急性和亚急性早期有吞咽困难体征的参与者被随机分为实验组(基于V-VST进行个体化饮食调整加常规标准护理,n = 53)和对照组(仅接受常规护理,n = 54)。评估干预前后的肺炎发生率、功能性经口摄入量表(FOIS)评分和饮食评估工具(EAT-10)得分。

结果

实验组的肺炎发生率显著低于对照组(p < 0.05)。在功能性经口摄入量和生活质量方面发现了显著的组间差异,干预后实验组的FOIS评分显著更高,EAT-10得分显著更低(p < 0.001)。

结论

这些发现表明,尽管V-VST是一种非仪器筛查工具,但它可以促进个体化饮食调整,并且可能是降低脑出血后吞咽困难患者肺炎风险、改善功能性经口摄入量和提高生活质量的有效临床选择。未来的研究应探索如何基于国际吞咽困难饮食标准化倡议框架更精确地实施饮食调整。

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本文引用的文献

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Noninstrumental Dysphagia Assessment and Screening: A Proposed Checklist.非仪器性吞咽障碍评估和筛查:一个建议的检查表。
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Dysphagia after ischemic and hemorrhagic stroke: A propensity-matched 20-year analysis of the national inpatient sample.缺血性和出血性卒后吞咽困难:全国住院患者样本的倾向性匹配 20 年分析。
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The sensitivity and specificity of the modified volume-viscosity swallow test for dysphagia screening among neurological patients.改良容量 - 黏度吞咽试验在神经系统疾病患者吞咽困难筛查中的敏感性和特异性
Front Neurol. 2022 Sep 16;13:961893. doi: 10.3389/fneur.2022.961893. eCollection 2022.
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Diagnostic Accuracy of the Eating Assessment Tool-10 (EAT-10) in Screening Dysphagia: A Systematic Review and Meta-Analysis.《进食评估工具-10(EAT-10)在吞咽障碍筛查中的诊断准确性:系统评价和荟萃分析》。
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Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis.急性脑卒中患者吞咽困难的发生率、肺炎风险和死亡率的 Meta 分析。
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Mortality from Aspiration Pneumonia: Incidence, Trends, and Risk Factors.吸入性肺炎死亡率:发生率、趋势和危险因素。
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