Diagnosis and treatment of neurogenic dysphagia - S1 guideline of the German Society of Neurology.
Diagnosis and treatment of neurogenic dysphagia - S1 guideline of the German Society of Neurology.
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DOI：
10.1186/s42466-021-00122-3
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发表时间：
2021-05-04
影响因子：
--
通讯作者：
Pflug C
中科院分区：
文献类型：
--
作者：
Dziewas R;Allescher HD;Aroyo I;Bartolome G;Beilenhoff U;Bohlender J;Breitbach-Snowdon H;Fheodoroff K;Glahn J;Heppner HJ;Hörmann K;Ledl C;Lücking C;Pokieser P;Schefold JC;Schröter-Morasch H;Schweikert K;Sparing R;Trapl-Grundschober M;Wallesch C;Warnecke T;Werner CJ;Weßling J;Wirth R;Pflug C
神经性吞咽困难是指由中枢和周围神经系统、神经肌肉传导或肌肉疾病引起的吞咽障碍。神经源性吞咽困难是许多神经系统疾病中最常见也是最危险的症状之一。其最重要的后遗症包括吸入性肺炎、营养不良和脱水，受影响的患者往往需要长期护理，并面临更高的死亡率。通过对相关的原始论文、综述文章、国际指南以及对神经源性吞咽困难诊断和治疗的调查研究，来自27个医学学会的吞咽困难专家发起了一个共识过程。本指南由53条建议组成，第一部分涵盖了整个诊断范围，从吞咽困难的特定病史、最初的吞咽困难筛查和临床评估，到更精细的仪器程序，如灵活的内镜吞咽评估、视频透视吞咽研究和高分辨率压力测量。此外，特定的临床场景被捕获，其中包括对鼻胃管和气管切开管患者的管理。本指南的第二部分致力于神经性吞咽困难的治疗。除了饮食干预和行为吞咽治疗外，还讨论了改善口腔卫生的干预措施、药物治疗选择、不同形式的神经刺激以及微创和外科治疗。神经源性吞咽困难的诊断和治疗具有挑战性，需要不同医学专业的共同努力。虽然支持实施吞咽困难筛查的证据相当有说服力，但需要进一步的试验来提高证据质量，以获得更精细的吞咽困难诊断方法，特别是神经源性吞咽困难的不同治疗选择。本文是最近发表在网上（https://www.awmf.org/uploads/tx_szleitlinien/030-111l_Neurogene-Dysphagie_2020-05.pdf）的指南的节选和翻译版本。
Neurogenic dysphagia defines swallowing disorders caused by diseases of the central and peripheral nervous system, neuromuscular transmission, or muscles. Neurogenic dysphagia is one of the most common and at the same time most dangerous symptoms of many neurological diseases. Its most important sequelae include aspiration pneumonia, malnutrition and dehydration, and affected patients more often require long-term care and are exposed to an increased mortality. Based on a systematic pubmed research of related original papers, review articles, international guidelines and surveys about the diagnostics and treatment of neurogenic dysphagia, a consensus process was initiated, which included dysphagia experts from 27 medical societies. This guideline consists of 53 recommendations covering in its first part the whole diagnostic spectrum from the dysphagia specific medical history, initial dysphagia screening and clinical assessment, to more refined instrumental procedures, such as flexible endoscopic evaluation of swallowing, the videofluoroscopic swallowing study and high-resolution manometry. In addition, specific clinical scenarios are captured, among others the management of patients with nasogastric and tracheotomy tubes. The second part of this guideline is dedicated to the treatment of neurogenic dysphagia. Apart from dietary interventions and behavioral swallowing treatment, interventions to improve oral hygiene, pharmacological treatment options, different modalities of neurostimulation as well as minimally invasive and surgical therapies are dealt with. The diagnosis and treatment of neurogenic dysphagia is challenging and requires a joined effort of different medical professions. While the evidence supporting the implementation of dysphagia screening is rather convincing, further trials are needed to improve the quality of evidence for more refined methods of dysphagia diagnostics and, in particular, the different treatment options of neurogenic dysphagia. The present article is an abridged and translated version of the guideline recently published online (https://www.awmf.org/uploads/tx_szleitlinien/030-111l_Neurogene-Dysphagie_2020-05.pdf).
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影响因子：
3.6
作者：
Balou, Matina;Herzberg, Erica G.;Molfenter, Sonja M.
通讯作者：
Molfenter, Sonja M.
DOI：
10.1016/j.jstrokecerebrovasdis.2013.09.031
发表时间：
2014-03-01
影响因子：
2.5
作者：
Bax, Louise;McFarlane, Mary;Miles, Anna
通讯作者：
Miles, Anna
影响因子：
2.6
作者：
Balou, Matina;McCullough, Gary H.;Guidry, Tiffany
通讯作者：
Guidry, Tiffany
DOI：
10.1016/j.wjorl.2018.05.003
发表时间：
2018-06
期刊：
World journal of otorhinolaryngology - head and neck surgery
影响因子：
--
作者：
Anis MM;Memon Z
通讯作者：
Memon Z
影响因子：
8.3
作者：
Bath PM;Scutt P;Love J;Clavé P;Cohen D;Dziewas R;Iversen HK;Ledl C;Ragab S;Soda H;Warusevitane A;Woisard V;Hamdy S;Swallowing Treatment Using Pharyngeal Electrical Stimulation (STEPS) Trial Investigators
通讯作者：
Swallowing Treatment Using Pharyngeal Electrical Stimulation (STEPS) Trial Investigators