在中风后食症中药物管理:评估固体剂量形式的吞安全性
Michaela Trapl-Grundschober1,2,3, Walter Struhal1,2, Yvonne Teuschl4
1Karl Landsteiner University of Health Sciences, Krems, Lower Austria, Austria (M.T.-G., W.S.).
Stroke
|July 16, 2025
概括
对于患有失消性中风的中风患者,粉碎固体剂型 (SDF) 可能不比整片药片更安全,并可能增加残留物. 纤维光学内镜评估吞 (FEES) 可以指导更安全的药物管理.
科学领域:
- 神经学 神经学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 脑卒中后食障碍影响高达75%的患者,需要进行标准化查.
- 目前的指南建议药物评估,但缺乏对固体剂量形式 (SDF) 的验证工具.
- 粉碎药片是减少吸入风险的常见做法,但其安全性和有效性仍未得到评估.
研究的目的:
- 在急性中风患者中,比较吞粉碎与整片安慰剂片的安全性和效率.
- 评估与不同的固体剂型 (SDF) 施用方法相关的吸收和喉残留的风险.
- 提供指导性证据,以指导缩性中风患者安全服用药物.
主要方法:
- 一项前性,单中心,横截面研究,涉及60名急性中风患者.
- 纤维光学内镜吞评估 (FEES) 用于评估吞1个粉碎和3个整个安慰剂片与果.
- 主要结果:危险吞的发生率 (透吸收量表);次要结果:喉残留物存在和位置.
主要成果:
- 所有154个完全吞的整片药片都是安全的;没有透或吸入.
- 不安全的吞发生在14.3%的伴随波利和12.1%的压碎的SDF中,没有显著的差异.
- 压碎的SDF导致了显著更多的谷状残留物 (P<0.001).
结论:
- 对于缺血性中风患者,应重新考虑SDF的例行压碎.
- 整个SDF,如果通过FEES被认为是安全的,可能是一个更好的替代方案.
- 使用FEES可以指导更安全的药物管理,潜在地提高疗效和减少错误.
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