Silent aspiration: What do we know?
Silent aspiration: What do we know?
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DOI：
10.1007/s00455-005-0018-9
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发表时间：
2005-06-01
期刊：
影响因子：
2.6
通讯作者：
Kalra, L
中科院分区：
文献类型：
--
作者：
Ramsey, D;Smithard, D;Kalra, L
虽然临床上明显的误吸在吞咽困难受试者中很常见，但很大一部分可能是无声误吸，即，没有任何吞咽困难的迹象本文回顾了有关无症状性误吸的患病率、病因和预后意义的文献。使用无声误吸、误吸、吞咽困难和卒中作为检索词进行电子数据库检索，并手动检索文献。无声吸入已被描述在许多条件和亚组的患者（包括正常人），使用一些检测方法，使比较的挑战。最好的数据是急性中风，其中2%-25%的患者可能会无声地吸入。与无声误吸相关的机制可能包括咽部肌肉组织的中枢或局部无力/不协调、喉咽感觉降低、产生反射性咳嗽的能力受损以及P物质或多巴胺水平低。在预后方面，在许多但不是所有的研究中，无声吸入与发病率和死亡率的增加有关。然而，在健康个体中，夜间一定程度的无声吸气可能是正常的。对无声误吸的现象了解甚少，需要进一步研究以改进检测方法，从而更好地确定其患病率和预后意义。
Although clinically evident aspiration is common in subjects with dysphagia, a significant proportion may aspirate silently, i.e., without any outward signs of swallowing difficulty. This article reviews the literature on the prevalence, etiology, and prognostic significance of silent aspiration. An electronic database search was performed using silent aspiration, aspiration, dysphagia, and stroke as search terms, together with hand-searching of articles. Silent aspiration has been described in many conditions and subgroups of patients (including normal individuals), using a number of detection methods, making comparisons a challenge. The best data are for acute stroke, in which 2%-25% of patients may aspirate silently. Mechanisms associated with silent aspiration may include central or local weakness/incoordination of the pharyngeal musculature, reduced laryngopharyngeal sensation, impaired ability to produce a reflexive cough, and low substance P or dopamine levels. In terms of prognosis, silent aspiration has been associated with increased morbidity and mortality in many but not all studies. However, some degree of silent aspiration at night may be normal in healthy individuals. The phenomenon of silent aspiration is poorly understood and further research is needed to improve methods of detection and thereby better define its prevalence and prognostic significance.