Safety and Clinical Benefits of Laryngeal Closure in Patients with Amyotrophic Lateral Sclerosis.
Safety and Clinical Benefits of Laryngeal Closure in Patients with Amyotrophic Lateral Sclerosis.
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作者：
本研究评估了肌萎缩侧索硬化症（ALS）患者喉部闭合的安全性和术后吞咽功能的变化，并为ALS患者提出了合适的手术策略。回顾性分析 2003 年至 2020 年在日本名古屋大学医院连续 26 例接受喉闭合术的 ALS 患者的临床和手术数据。使用神经肌肉疾病吞咽状态量表 (NdSSS) 和功能性口腔摄入量表 (FOIS) 评估术前和术后约 1 个月吞咽功能的变化。中位手术时间为 126 分钟（范围：51-163 分钟），中位术中失血量为 20 mL（范围：0-88 mL）。 26 例接受喉部封闭的 ALS 患者中，3 例（12%）发生 1 级（轻度）并发症；然而，没有观察到严重的并发症。术后，25 名患者（96%）维持吞咽功能，只有 1 名患者（4%）NdSSS 和 FOIS 评分恶化。术后没有患者因严重吸入性肺炎转诊至我院。两名患者术后不再需要饲管，恢复经口进食。喉部闭合可能是预防慢性误吸的安全手术方法，也可以维持 ALS 患者的吞咽功能。需要使用金标准吞咽电视荧光镜检查进行进一步的多中心前瞻性研究来支持我们的发现。在线版本包含可在 10.1007/s00455-022-10454-0 获取的补充材料。
This study evaluated the safety of laryngeal closure and post-surgical changes in swallowing function of patients with amyotrophic lateral sclerosis (ALS) and proposed an appropriate surgical strategy for patients with ALS. Clinical and surgical data of 26 consecutive patients with ALS who underwent laryngeal closure at Nagoya University Hospital in Japan between 2003 and 2020 were retrospectively analyzed. Changes in swallowing functions were evaluated before and approximately 1 month post-surgery using Neuromuscular Disease Swallowing Status Scale (NdSSS), and Functional Oral Intake Scale (FOIS). The median operation time was 126 min (range, 51–163 min), and the median intraoperative blood loss was 20 mL (range, 0–88 mL). Among the 26 ALS patients who underwent laryngeal closure, grade 1 (mild) complications occurred in three patients (12%); however, no severe complications were observed. After surgery, 25 patients (96%) maintained the swallowing function and only one patient (4%) had deteriorating NdSSS and FOIS scores. No patients were referred to our hospital due to severe aspiration pneumonia after the surgery. Two patients did not require a feeding tube after the surgery and returned to oral intake. Laryngeal closure may be a safe surgical procedure for preventing chronic aspiration and may also maintain swallowing function of patients with ALS. Further multicenter prospective studies using the gold standard videofluoroscopic swallowing examination are required to support our findings. The online version contains supplementary material available at 10.1007/s00455-022-10454-0.
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影响因子：
5.6
作者：
Alfonsi E;Restivo DA;Cosentino G;De Icco R;Bertino G;Schindler A;Todisco M;Fresia M;Cortese A;Prunetti P;Ramusino MC;Moglia A;Sandrini G;Tassorelli C
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1.7
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2.6
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