Dysphagia and respiratory care in individuals with tetraplegia: incidence, associated factors, and preventable complications.
Dysphagia and respiratory care in individuals with tetraplegia: incidence, associated factors, and preventable complications.
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四肢瘫痪患者的吞咽困难和呼吸护理：发病率、相关因素和可预防的并发症。
DOI：
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发表时间：
2012
影响因子：
2.9
通讯作者：
S. Kolakowsky
中科院分区：
文献类型：
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作者：
K. Shem;K. Castillo;S. Wong;James Chang;S. Kolakowsky
吞咽困难发生在显著数量的个体脊髓损伤（SCI）呈现急性护理和住院康复。这项前瞻性研究发现，近40%的四肢瘫痪患者存在吞咽困难。气管切开术、机械通气、鼻胃管和年龄是重要的危险因素。脊髓损伤患者吞咽困难的并发症可导致严重的发病率和延迟康复。因此，早期和准确的诊断吞咽困难是必要的，以减少发展危及生命的并发症的风险。本文介绍了吞咽困难的发生率和危险因素，以及使用床边吞咽评估（BSE）和视频透视吞咽研究（VFSS）诊断吞咽困难。本文讨论了呼吸治疗师在治疗有吞咽困难的脊髓损伤患者时经常被低估的作用，包括辅助咳嗽、高潮气量通气和使用Passy-Muir瓣膜。改善的分泌管理和呼吸稳定使吞咽困难的个体能够更快、更安全地由语言病理学家进行评估。早期评估和干预可以改善发病率和延迟康复，从而改善整体临床结果。
Dysphagia occurs in a significant number of individuals with spinal cord injury (SCI) presenting to acute care and inpatient rehabilitation. This prospective study has found dysphagia in nearly 40% of individuals with tetraplegia. Tracheostomy, mechanical ventilation, nasogastric tube, and age are significant risk factors. The detrimental complications of dysphagia in SCI can cause significant morbidity and delays in rehabilitation. Thus, early and accurate diagnosis of dysphagia is imperative to reduce the risk of developing life-threatening complications. Incidence and risk factors of dysphagia and the use of the bedside swallow evaluation (BSE) and videofluoroscopy swallow study (VFSS) to diagnose dysphagia are presented. The often underappreciated role of respiratory therapists, including assist cough, high tidal volume ventilation, and the use of Passy-Muir valve, in the care of individuals with SCI who have dysphagia is discussed. Improved secretion management and respiratory stabilization enable the individuals with dysphagia to be evaluated sooner and safely by a speech pathologist. Early evaluation and intervention could improve upon morbidity and delayed rehabilitation, thus improving overall clinical outcomes.