The Effects of the VFSS Timing After Nasogastric Tube Removal on Swallowing Function of the Patients With Dysphagia
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objective To evaluate the effects of the videofluoroscopic swallowing study (VFSS) timing after the nasogastric tube (NGT) removal on swallowing function of the patients with dysphagia.Methods This study was conducted on 40 NGT-fed patients with dysphagia. To assess the patients’ swallowing function, VFSS was performed twice using a 5-mL 35% diluted barium solution. For the initial examination, VFSS was performed immediately after the NGT removal (VFSS 1). For the second examination, VFSS was performed five hours after the NGT removal (VFSS 2). We used the functional dysphagia scale (FDS) to assess swallowing function. In the FDS, a significant difference in the four items in the oral phase, seven items in the pharyngeal phase, and total scores were assessed (p<0.05). We also used modified penetration-aspiration scale (mPAS) to compare the two examinations (p<0.05).Results A paired t-test was performed to confirm the statistical significance of the two examinations (p<0.05). The overall swallowing function was assessed as better in VFSS 2 than in VFSS 1. In the FDS, significant differences in the residue in valleculae (p=0.002), the residue in pyriform sinuses (p=0.001), the coating of pharyngeal wall after swallow (p=0.001), and the total scores (p<0.001) were found between the two examinations. Also, in the mPAS that assessed the degree of penetration-aspiration, a significant difference was found between the two examinations (p<0.001).Conclusion The results of this study confirmed that the timing of the VFSS after the NGT removal affects the swallowing function. Thus, to accurately assess the swallowing function, VFSS must be performed in NGT-fed patients after they have rested for a certain period following the removal of their NGT.
Abstract
Objective To evaluate the effects of the videofluoroscopic swallowing study (VFSS) timing after the nasogastric tube (NGT) removal on swallowing function of the patients with dysphagia.Methods This study was conducted on 40 NGT-fed patients with dysphagia. To assess the patients’ swallowing function, VFSS was performed twice using a 5-mL 35% diluted barium solution. For the initial examination, VFSS was performed immediately after the NGT removal (VFSS 1). For the second examination, VFSS was performed five hours after the NGT removal (VFSS 2). We used the functional dysphagia scale (FDS) to assess swallowing function. In the FDS, a significant difference in the four items in the oral phase, seven items in the pharyngeal phase, and total scores were assessed (p<0.05). We also used modified penetration-aspiration scale (mPAS) to compare the two examinations (p<0.05).Results A paired t-test was performed to confirm the statistical significance of the two examinations (p<0.05). The overall swallowing function was assessed as better in VFSS 2 than in VFSS 1. In the FDS, significant differences in the residue in valleculae (p=0.002), the residue in pyriform sinuses (p=0.001), the coating of pharyngeal wall after swallow (p=0.001), and the total scores (p<0.001) were found between the two examinations. Also, in the mPAS that assessed the degree of penetration-aspiration, a significant difference was found between the two examinations (p<0.001).Conclusion The results of this study confirmed that the timing of the VFSS after the NGT removal affects the swallowing function. Thus, to accurately assess the swallowing function, VFSS must be performed in NGT-fed patients after they have rested for a certain period following the removal of their NGT.
참고문헌 (14)
- Smithard DG, "Complications and outcome after acute stroke. Does dysphagia matter?", Stroke, 27, pp.1200~1204 (1996)
- Finestone HM, "Malnutrition in stroke patients on the rehabilitation service and at follow-up: prevalence and predictors", Arch Phys Med Rehabil, 76, pp.310~316 (1995)
- Palmer JB, "Physical medicine and rehabilitation", pp.581~597 (2011), Saunders
- 정세희, "비디오 투시 연하 검사에 근거한 연하곤란 임상 척도의 타당도 평가", Annals of Rehabilitation Medicine, 29(4), pp.343~350 (2005), 대한재활의학회
- Eyal H., "Evaluation and treatment of swallowing disorders (dysphagia): the American model as an opportunity for improving patient care and cost containment in Israel’s healthcare system", Harefuah, 132, pp.775~778 (1997)
- Han TR, "Quantifying swallowing function after stroke: a functional dysphagia scale based on videofluoroscopic studies.", Arch Phys Med Rehabil, 82, pp.677~682 (2001)
- American Speech-Language-Hearing Association, "Adult speech language pathology training manual", American Speech-Language-Hearing Association, ~ (1998)
- 백남종, "비디오 투시 연하 검사에 기초한 기능적 연하곤란 척도의 임상적 타당도", Annals of Rehabilitation Medicine, 29(1), pp.43~49 (2005), 대한재활의학회
- Rosenbek JC, "A penetration-aspiration scale", Dysphagia, 11, pp.93~98 (1996)
- 김정윤, "The Diagnostic Usefulness of the Fiberoptic Endoscopic Evaluation of Swallowing", Annals of Rehabilitation Medicine, 35(1), pp.14~22 (2011), 대한재활의학회
- Wang TG, "The effect of nasogastric tubes on swallowing function in persons with dysphagia following stroke", Arch Phys Med Rehabil, 87, pp.1270~1273 (2006)
- Cook IJ, "Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing", Dysphagia, 4, pp.8~15 (1989)
- Perlman AL, "Electromyographic activity from human laryngeal, pharyngeal, and submental muscles during swallowing", J Appl Physiol, 86, pp.1663~1669 (1999)
- Gomes CA Jr, "Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances", Cochrane Database Syst Rev, 3, pp.CD008096~ (2012)