气管食管改道(TED)可以防止吞咽障碍和/或重复性吸入性肺炎患者对呼吸系统的损害;但是,TED可能会导致发声的损失。我们先前的研究表明,采用气管食管穿刺(TEP)的TED可以防止误吸,同时保留发声。在这项研究中,我们旨在进一步评估TEP患者的进食状态和发声情况,以验证该手术的可重复性.
案例系列研究。
我们回顾性回顾了2017年2月至2019年8月在福冈三野医院接受TEP治疗顽固性抽吸的11例患者的医疗记录。我们评估了术前穿刺抽吸评分(PPAS),日常活动,术前和术后食物摄入水平量表(FILS)评分,营养途径,最大发声时间(MPT),和术后沟通方法。
研究人群包括10名男性和1名女性(平均年龄,66年;范围,44-81),PPAS为6.8±1.0。FILS评分由术前2.1±0.5变化为术后7.5±2.0(配对t检验,P<.05),而MPT从7.9±4.1变为10.3±4.2s(配对t检验,P=.9)。术前,胃瘘(8例[73%])是主要的营养途径,其次是胃管(两名患者[18%])。术后,八名患者(73%)的主要营养途径是口服,而其余3名患者(27%)偶尔使用口服途径。所有患者均保持喉发声功能,八位(73%)仅使用喉部发声进行交流。
希望保留发声功能的顽固性误吸患者应建议接受TEP的TED治疗。
4喉镜,131:E1965-E1970,2021.
Tracheoesophageal diversion (TED) can prevent damage to the respiratory system in patients with swallowing disorders and/or repetitive aspiration pneumonia; however, TED may cause the loss of phonation. Our previous study demonstrated that TED with tracheoesophageal puncture (TEP) prevents aspiration while retaining phonation. In this study, we aimed to further evaluate the feeding status and phonation of patients who underwent TED with TEP to verify the reproducibility of this procedure.
Case series study.
We retrospectively reviewed the medical records of 11 patients who underwent TED with TEP for intractable aspiration from February 2017 to August 2019 at Fukuoka Sanno Hospital. We evaluated the preoperative penetration aspiration score (PPAS), daily activities, preoperative and postoperative food intake level scale (FILS) score, nutrition route, maximum phonation time(MPT), and postoperative communication method.
The study population included 10 men and 1 woman (mean age, 66 years; range, 44-81) with a PPAS of 6.8 ± 1.0. The FILS score changed from 2.1 ± 0.5 preoperatively to 7.5 ± 2.0 postoperatively (paired t-test, P < .05), while the MPT changed from 7.9 ± 4.1 to 10.3 ± 4.2 s (paired t-test, P = .9). Preoperatively, a gastric fistula (eight patients [73%]) was the main nutrition route, followed by a gastric tube (two patients [18%]). Postoperatively, the main nutritional route for eight patients (73%) was oral, while the remaining three patients (27%) used the oral route occasionally. All patients maintained laryngeal phonation function, and eight (73%) used only laryngeal phonation for communication.
Patients with intractable aspiration who wish to retain phonatory function should be advised to undergo TED with TEP.
4 Laryngoscope, 131:E1965-E1970, 2021.