Respiratory-swallowing coordination and swallowing safety in patients with Parkinson's disease.
Respiratory-swallowing coordination and swallowing safety in patients with Parkinson's disease.
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DOI：
10.1007/s00455-010-9289-x
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发表时间：
2011-09
期刊：
影响因子：
2.6
通讯作者：
Sapienza, Christine M.
中科院分区：
文献类型：
--
作者：
Troche, Michelle S.;Huebner, Irene;Rosenbek, John C.;Okun, Michael S.;Sapienza, Christine M.
关键词：
本研究的目的是确定帕金森病 (PD) 患者在吞咽稀液体时是否表现出异常呼吸事件。此外，本研究试图确定呼吸事件、吞咽呼吸暂停持续时间和穿透-误吸（P-A）量表评分之间的关联。 39 名 PD 患者接受了 10 次 5 毫升稀液体推注试验。 P-A 量表评分量化了吞咽 3 盎司连续推注期间是否存在穿透和误吸。根据 3 盎司连续吞咽过程中判断的吞咽安全性，将参与者分为两组：第 1 组 = P–A ≤ 2；第 1 组 = P–A ≤ 2；第 2 组 = P–A ≥ 3。使用视频荧光镜结合鼻插管对燕子进行检查，以记录事件期间的呼吸信号。研究结果表明，呼气是吞咽呼吸暂停前后的主要呼吸事件。数据显示，我们的队列与文献中报告的健康成年人吞咽后事件的百分比没有差异。此外，根据 P-A 量表测量，吞咽安全性较低的个体更有可能在吞咽后进行激发，并且吞咽呼吸暂停持续时间较短。吞咽前吸气的人吞咽呼吸暂停的持续时间也更长。吞咽后吸气事件的发生和吞咽呼吸暂停持续时间较短的发生可能是对有吞咽或误吸风险的 PD 患者进行临床吞咽评估时的重要指标。
The purpose of this study was to determine if individuals with Parkinson’s disease (PD) demonstrate abnormal respiratory events when swallowing thin liquids. In addition, this study sought to define associations between respiratory events, swallowing apnea duration, and penetration–aspiration (P–A) scale scores. Thirty-nine individuals with PD were administered ten trials of a 5-ml thin liquid bolus. P–A scale score quantified the presence of penetration and aspiration during the swallowing of a 3-oz sequential bolus. Participants were divided into two groups based on swallowing safety judged during the 3-oz sequential swallowing: Group 1 = P–A ≤ 2; Group 2 = P–A ≥ 3. Swallows were examined using videofluoroscopy coupled with a nasal cannula to record respiratory signals during the event(s). Findings indicated that expiration was the predominant respiratory event before and after swallowing apnea. The data revealed no differences in our cohort versus the percentages of post-swallowing events reported in the literature for healthy adults. In addition, individuals with decreased swallowing safety, as measured by the P–A scale, were more likely to inspire after swallows and to have shorter swallowing apnea duration. Individuals who inspired before swallow also had longer swallowing apnea duration. The occurrence of inspiratory events after a swallow and the occurrence of shorter swallowing apnea durations may serve as important indicators during clinical swallowing assessments in patients at risk for penetration or aspiration with PD.
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