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吞咽困难的中风患者的改良钡餐检查

Modified barium swallow examination in dysphagic stroke patients.

作者信息

Khoo J B, Buller A S, Wong M C

机构信息

Department of Diagnostic Radiology, Singapore General Hospital, Singapore.

出版信息

Singapore Med J. 1996 Aug;37(4):407-10.

PMID:8993144
Abstract

UNLABELLED

Aspiration in dysphagic stroke patients is common and causes significant morbidity and mortality. Bedside clinical assessment of aspiration risk is often unreliable, particularly in patients with silent aspiration. Twenty-five dysphagic stroke patients clinically assessed to have borderline risk of aspiration were studied using a Modified Barium Swallow (MBS) examination. MBS revealed definite aspiration of liquids in 6 patients (24%) and semisolids in 4 patients (16%). Combined clinical and MBS assessment revealed an additional 12 patients (48%) had problems swallowing liquids and 5 patients (20%) semisolids due to reasons other than aspiration. In total, oral feeding of liquids were contraindicated in 18 patients (72%) and semisolids in 9 patients (36%).

IN CONCLUSION

(1) In dysphagic stroke patients assessed clinically to have borderline risk of aspiration, MBS can distinguish those who aspirate from those who do not. MBS can also identify patients with other swallowing problems which expose them to potential aspiration. (2) Aspiration risk with food of various consistencies can be clearly defined, thus guiding the choice of food consistency and safe feeding methods.

摘要

未标注

吞咽困难的中风患者发生误吸很常见,会导致显著的发病率和死亡率。床边对误吸风险的临床评估往往不可靠,尤其是在隐性误吸患者中。对25例临床评估为误吸风险临界的吞咽困难中风患者进行了改良钡餐吞咽(MBS)检查。MBS显示6例患者(24%)存在明确的液体误吸,4例患者(16%)存在半固体误吸。临床和MBS联合评估显示,另有12例患者(48%)因误吸以外的原因存在吞咽液体困难,5例患者(20%)存在吞咽半固体困难。总体而言,18例患者(72%)禁忌经口摄入液体,9例患者(36%)禁忌经口摄入半固体。

结论

(1)对于临床评估为误吸风险临界的吞咽困难中风患者,MBS可以区分有误吸和无误吸的患者。MBS还可以识别出有其他吞咽问题从而有潜在误吸风险的患者。(2)可以明确不同黏稠度食物的误吸风险,从而指导食物黏稠度的选择和安全的喂养方法。

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