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Rehabilitation Practice and Science

Translated Title

使用吞嚥內視鏡評估腦中風吞嚥障礙病人使用下頜回收法之效益

Abstract

Background and Purpose: Dysphagia is a frequent symptom after stroke. Dysphagia increases the risk of aspiration pneumonia, malnutrition, and is associated with poor prognosis. Fiberoptic endoscopic evaluation of swallowing (FEES) is a suitable method for dysphagia assessment after acute stroke. Chin-tuck position has been used in dysphagia patients to prevent aspiration during swallowing. But the combined application of these promising modalities has rarely been studied. We aimed to evaluate the effects of chin-tuck position in stroke patient with dysphagia evaluated by fiberoptic endoscopy. Methods: A total of 34 consecutive patients with first stroke were enrolled. FEES after swallowing was done before and after chin-tuck position for evaluation. The dysphagia was measured by the pharyngeal stasis condition and the fiberoptic endoscopic dysphagia severity scale (FEDSS). A telephone interview was arranged in 3 months. The patients were asked about body weight change, respiratory tract infection events and nasogastric tube (NG tube) usage. Results: In the patients with extra-brainstem stroke, the pharyngeal stasis condition and FEDSS improved significantly with chin-tuck position. Furthermore, the brainstem stroke patient had better FEDSS with chin-tuck position. The 3-month NG tube removal rate was better in the patients who had better FEDSS. Conclusion: A baseline FEES examination provides valuable prognostic information for the choice of dysphagia managementin acute stroke patients. Chin-tuck is a better management of dysphagia in patients with extra-brainstem stroke. The 3-month NG tube removal rate was increased in the patients who had less severity by FEDSS.

Language

Traditional Chinese

First Page

1

Last Page

7

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