Rogers B T, Arvedson J, Msall M, Demerath R R
Division of Developmental Pediatrics, Children's Hospital of Buffalo, State University of New York 14209.
Dev Med Child Neurol. 1993 Jan;35(1):3-10. doi: 10.1111/j.1469-8749.1993.tb11545.x.
Oral feeding of children with severe dysphagia and multiple disabilities may result in hypoxemia. Pulse oximetry was used to monitor hemoglobin saturation (SpO2) during oral feeding of five children with multiple disabilities who were referred because of food refusal or coughing and fatigue during feeding. Modified barium videofluoroscopic swallow studies demonstrated deglutition abnormalities. SpO2 values were within the normal range at rest, but routine, upright oral feeding resulted in significant degrees of hypoxemia. The pharyngeal stage of deglutition was abnormal in all five children. In three, the periods of hypoxemia were dependent on food texture. Awareness of meal-time hypoxemia contributed to the decision to use gastrostomy-tube feedings for the other two children. Pulse oximetry during oral feeding should be considered for all children with severe dysphagia and multiple disabilities.
对患有严重吞咽困难和多重残疾的儿童进行经口喂食可能会导致低氧血症。在对五名因拒食或喂食期间咳嗽及疲劳而前来就诊的多重残疾儿童进行经口喂食时，使用脉搏血氧饱和度仪监测血红蛋白饱和度（SpO2）。改良钡剂视频荧光吞咽造影研究显示存在吞咽异常。静息时SpO2值在正常范围内，但常规的直立位经口喂食会导致明显程度的低氧血症。所有五名儿童的吞咽咽期均异常。其中三名儿童的低氧血症时期取决于食物质地。对进餐时低氧血症的认识促使为另外两名儿童决定采用胃造瘘管喂养。对于所有患有严重吞咽困难和多重残疾的儿童，均应考虑在经口喂食期间进行脉搏血氧饱和度监测。
