Gottlieb D, Brill S, Khvoles S, Kipnis S, Manevitch D
Stroke Rehabilitation Unit, Beth Rivka Geriatric Medical Center, Petah Tikva.
Harefuah. 1995 Jul;129(1-2):33-5, 78.
Aspiration pneumonia is a frequent complication of cerebrovascular accidents (CVA). It occurs mainly in those with post-CVA swallowing disorders, which can be diagnosed by bedside swallowing evaluation. Evaluation is based on observation of components of the oral and pharyngeal stages of swallowing a drink of 50 ml of clear liquid. Changing the consistency of the diet and the mode of swallowing, following its evaluation, can reduce significantly the frequency of post-CVA aspiration pneumonia. In 180 patients admitted for stroke rehabilitation, aspiration pneumonia occurred in 10% and swallowing disorders were found in 28%. Planned swallowing evaluation followed by the above regimen was associated with a gradual reduction of pneumonia from 16% in the first group of 60 patients to 3% in the second group of 60; and of patients with dysphagia, from 27% in the first group to none in the second.
吸入性肺炎是脑血管意外(CVA)常见的并发症。它主要发生在CVA后有吞咽障碍的患者中,可通过床边吞咽评估进行诊断。评估基于观察吞咽50毫升清水时口腔和咽部阶段的各项表现。在评估后改变饮食的稠度和吞咽方式,可显著降低CVA后吸入性肺炎的发生率。在180例因中风康复入院的患者中,10%发生了吸入性肺炎,28%存在吞咽障碍。按照上述方案进行有计划的吞咽评估,可使肺炎发生率从第一组60例患者中的16%逐渐降至第二组60例患者中的3%;吞咽困难患者的肺炎发生率从第一组的27%降至第二组的零。