Selley W G, Roche M T, Pearce V R, Ellis R E, Flack F C
Department of Physics, University of Exeter, U.K.
Dysphagia. 1995 Winter;10(1):32-5. doi: 10.1007/BF00261277.
A retrospective study was undertaken to evaluate the progress of a group of dysphagic stroke patients for whom a dental prosthesis the Palatal Training Appliance (PTA), was used in the active rehabilitation of the swallowing mechanism. Patients selected were those who had sustained a stroke uncomplicated by other neurological illness, during one 12-month period, and whose dysphagia caused anxiety to the medical staff in the hospital ward. Thirty severely dysphagic stroke patients satisfied these criteria. The study recorded the duration and type of supplementary feeding required during hospitalization. Thirteen patients had evidence of aspiration before the PTA was fitted and 5 afterwards. Seven patients died, but only 1 was recorded as having a febrile illness which may have contributed to the death. At discharge, which averaged 10 weeks after admission, 22 of the 23 survivors were taking an adequate oral diet. It was also noted that almost half of the patients who wore dentures before the cerebrovascular event were unable to control them afterwards, adding to their neurological swallowing difficulties. The fitting of a PTA and correction of unstable dentures appeared to help both motivation and function. The results show an improvement in the rehabilitation of oral feeding compared with previous reports by other authors, who did not use the dental appliance. There did not appear to be any medical contraindication to its use.
进行了一项回顾性研究，以评估一组吞咽困难的中风患者的进展情况，这些患者在吞咽机制的积极康复中使用了一种假牙——腭部训练矫治器（PTA）。所选患者为在一个12个月期间发生中风且无其他神经系统疾病并发症，并且其吞咽困难使医院病房的医护人员感到焦虑的患者。30名严重吞咽困难的中风患者符合这些标准。该研究记录了住院期间所需补充喂养的持续时间和类型。13名患者在安装PTA之前有误吸迹象，之后有5名。7名患者死亡，但只有1名被记录为患有可能导致死亡的发热性疾病。出院时（入院后平均10周），23名幸存者中有22名能够正常经口进食。还注意到，几乎一半在脑血管事件发生前佩戴假牙的患者此后无法控制假牙，这增加了他们神经源性吞咽困难的程度。安装PTA和矫正不稳定假牙似乎对患者的积极性和功能都有帮助。结果表明，与其他未使用该牙科矫治器的作者之前的报告相比，经口喂养的康复情况有所改善。使用该矫治器似乎没有任何医学上的禁忌证。
