沉默愿望的危险因素:一个回顾案例系列和文献综述
Barbara Jamróz1, Maria Sobol2, Joanna Chmielewska-Walczak3
1Clinical Department of Otolaryngology, National Medical Institute of the Interior and Administration, Warsaw, Poland.
沉默的吸收会影响20%-30%的患者,往往没有症状. 脑神经 (IX,X),气管切除术或放射治疗的患者需要优先进行吞评估,以检测静音吸入风险.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 神经学 神经学
- 吞障碍 吞障碍 吞障碍
背景情况:
- 沉默的吸血,发生在20%-30%的患者,没有明显的临床症状如咳或声音变化.
- 沉默吸气的后果包括吸气性肺炎,复发性呼吸道感染,呼吸衰竭,营养不良和脱水.
- 临床吞检查可能会错过高达50%的静音吸入病例,突出需要客观评估.
研究的目的:
- 为了识别患有沉默吸血风险较高的患者.
- 通过使用单变逻辑回归来确定与无声期望相关的潜在模式和风险因素.
主要方法:
- 追溯分析455个光纤内镜评估吞 (FEES) 报告.
- 患者被分为神经系统疾病,头手术,胃肠道疾病和其他群体.
- 统变逻辑回归用于评估危险因素,包括神经,放射治疗和气管切除术.
主要成果:
- 在特定的患者群体中,沉默的透和吸收发生的频率显著增加 (p < 0.001).
- 液体和食物的透/吸收与所有组的唾液透/吸收相关 (p < 0.001).
- 神经 (IX,X),放射治疗和气管切除术是唾液透和吸入的重要危险因素 (p ≤0.020).
结论:
- 脑神经 (IX,X),气管切除术和接受放射治疗的患者有更高的静音吸收风险.
- 对于患有这些危险因素的患者,特别是那些吞困难的患者,建议优先进行仪器吞评估.
- 这些发现特别适用于头手术患者,指导临床检查和干预策略.
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