Outcomes of swallowing rehabilitation in chronic brainstem dysphagia: A retrospective evaluation
Outcomes of swallowing rehabilitation in chronic brainstem dysphagia: A retrospective evaluation
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DOI：
10.1007/pl00009593
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发表时间：
1999-03-01
期刊：
影响因子：
2.6
通讯作者：
Cannito, MP
中科院分区：
文献类型：
--
作者：
Huckabee, ML;Cannito, MP
本研究探讨了一组10例单一脑干损伤后慢性吞咽困难患者的功能和生理治疗结果。所有患者都参加了一个结构化的吞咽治疗计划，在一个大都市的教学医院。该方案与更传统的吞咽治疗不同之处在于将表面肌电图生物反馈作为治疗方式，并在干预的第一周完成10小时的直接治疗。对病历和患者问卷进行回顾性分析，以获得有关病史、病变部位、既往干预和患者吞咽恢复感知的信息。吞咽治疗中的生理变化，通过视频透视吞咽研究的严重程度评级来衡量，在治疗1周或10次后，10例患者中有9例表现出这种变化。治疗1周后、治疗6个月后和治疗1年后再次通过饮食水平耐受性测量功能变化。10名患者中有8名能够在终止胃造口管喂养后恢复完全经口进食，而2名患者的功能性吞咽没有长期变化。在8名恢复完全口服的患者中，治疗后至停药的管饲平均持续时间为5.3个月，范围为1-12个月。六名恢复口服摄入的患者保持吞咽功能的增加，两名患者由于新的不相关的医疗条件而恢复非口服营养。
This study examines the functional and physiologic outcomes of treatment in a group of 10 patients with chronic dysphagia subsequent to a single brainstem injury. All patients participated in a structured swallowing treatment program at a metropolitan teaching hospital. This program differs from more traditional swallowing treatment by the inclusion of surface electromyography biofeedback as a treatment modality and the completion of 10 hr of direct treatment in the first week of intervention. A retrospective analysis of medical records and patient questionnaires was used to gain information regarding medical history, site of lesion, prior interventions, and patient perception of swallowing recovery. Physiologic change in swallowing treatment, as measured by severity ratings of videofluoroscopic swallowing studies, was demonstrated in nine of 10 patients after 1 week or 10 sessions of treatment. Functional change was measured by diet level tolerance after 1 week of treatment, at 6 months, and again at I year posttreatment. Eight of the 10 patients were able to return to full oral intake with termination of gastrostomy tube feedings, whereas two demonstrated no long-term change in functional swallowing. Of the eight who returned to full oral intake, the average duration of tube feedings following treatment until discontinuation was 5.3 months, with a range of 1-12 months. Six patients who returned to oral intake maintained gains in swallowing function, and two patients returned to nonoral nutrition as the result of a new unrelated medical condition.