Rapid swallow improvement following Pharyngeal Electrical Stimulation in a COVID-19 patient with long-term severe neurogenic dysphagia: A case report
Rapid swallow improvement following Pharyngeal Electrical Stimulation in a COVID-19 patient with long-term severe neurogenic dysphagia: A case report
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患有长期严重神经源性吞咽困难的 COVID-19 患者接受咽部电刺激后吞咽功能迅速改善：病例报告
DOI：
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发表时间：
2021
影响因子：
3.5
通讯作者：
B. Basu
中科院分区：
文献类型：
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作者：
C. Blakemore;J. Hunter;B. Basu
本病例报告详细介绍了一位62岁男性患者的康复和预后，其严重吞咽障碍是由新冠肺炎肺炎、长时间插管和中风引起的。选择的治疗方法是传统的吞咽疗法和使用咽电刺激疗法(PES)超过5天的新方法。除了床边的吞咽评估外，还使用客观的仪器评估(即纤维内窥镜评估吞咽(费用)和视频透视)来监测恢复情况。在康复开始时，吞咽障碍很严重，患者依赖管状喂养来满足营养、水分和药物需求。在开始治疗的43天内，患者恢复了正常的液体和饮食，不再需要通过喂养管或补充剂来管理营养和水分。生活质量测量结果显示，患者的生活质量明显改善。PES治疗是安全的，似乎有助于更快的康复。吞咽障碍评分明显改善(吞咽困难结局和严重程度评分(DOSS)、穿透-吸入量表(PAS)减少、功能独立性和评估量表(FIM+FAM)增加、功能性口服进食量(FOIS)增加)，并在接下来的2周内进一步显著改善。刺激后43天，患者的饮食已恢复到正常的液体和固体。使用自行管理的吞咽生活质量(SWAL-QOL)问卷，患者报告吞咽困难相关负担显著减少，进食或饮酒时窒息的风险大大降低，发展为肺炎，自信心大幅增强(总分：PES前11分至PES后直接55分)。结论：新冠肺炎患者表现为卒中和插管相关的严重吞咽困难，PES是安全的，似乎有助于更快的恢复。
This case report details the rehabilitation and outcome of a 62-year-old man with severe swallowing impairment, caused by COVID-19 pneumonitis, prolonged intubation, and a stroke. Traditional swallowing therapies in addition to a novel approach using pharyngeal electrical stimulation therapy (PES) over 5 days were the chosen treatment approach. Recovery was monitored using objective instrumental assessments (i.e. fibreoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy) in addition to bedside swallowing assessments. At the start of the rehabilitation, swallowing impairment was severe, with the patient being dependent on tube feeding to meet nutrition, hydration, and medication needs. Within 43 days of commencing treatment the patient had returned to normal fluids and diet and no longer required support via a feeding tube or supplements to manage nutrition and hydration. Quality of life measures indicated significant improvement. PES treatment was safe and appeared to facilitate a faster recovery. using a clear improvement in dysphagia dysfunction scores (in-creased Dysphagia Outcome and Severity Scale (DOSS), reduced Penetration-Aspiration Scale (PAS), increased Functional Independent and Assessment Measure (FIM+FAM), and increased Functional Oral Intake Scale (FOIS)) was evident, and further significant improvement occurred in the following 2 weeks. Forty-three days post-stimulation, the patient’s diet had recovered to normal fluids and solids. Using self-administered Swallowing Quality of Life (SWAL-QoL) questionnaires, the patient reported a highly noticeable reduction in dysphagia-associated burden, a greatly decreased risk of choking when eating or drinking, developing pneumonia, and a large increase in self-confidence (total score: 11 pre-PES to 55 directly post-PES). Conclusion: In a patient with COVID-19 presenting with stroke and intubation-related severe dysphagia, PES was safe and appeared to facilitate faster recovery.
影响因子：
8.3
作者：
Broderick JP;Adeoye O;Elm J
通讯作者：
Elm J
影响因子：
29
作者：
Merkler, Alexander E.;Parikh, Neal S.;Navi, Babak B.
通讯作者：
Navi, Babak B.