2016年1月12日 星期二

常見嬰幼兒吞嚥障礙之原因(common causes of pediatric dysphagia)

 Common causes of pediatric dysphagia include..... 

˙ developmental disability (需長期的醫療資源/身心發展受損)

˙ neurological disorders(神經系統疾病
      e.g.,cerebral palsy (腦性麻痺), meningitis(腦膜炎), encephalopathy(腦病), 
            pervasive developmental disorders(廣泛性發展障礙),
            traumatic brain injury(TBI 創傷性腦損傷),
            muscle weakness in face and neck(臉部和頸部肌肉無力)

˙ factors affecting neuromuscular coordination (
影響神經肌肉協調之因素)
      e.g., prematurity(早產), low birth weight(出生體重過低)

˙complex medical conditions
     e.g., heart disease(心臟疾病), pulmonary disease(肺部疾病), 
             gastroesophageal reflux disease[GERD] (胃食道逆流), 
             delayed gastric emptying(胃排空延遲)

˙structural abnormalities
      e.g.,cleft lip and/or palate(/顎裂), laryngomalacia(軟喉症),
             head and neck abnormalities(頭頸部異常), 
             choanal atresia(後鼻口閉鎖)

˙genetic syndromes(
基因症狀)
      e.g., Pierre Robin, Prader-Willi, Treacher-Collins, 22q11 deletion

˙medication side effects(
藥物影響
      e.g., lethargy (嗜睡), decreased appetite(食慾下降)

˙sensory issues as a primary cause or secondary to limited food availability in early development 
  (感覺因素)
˙behavioral factors(行為因素) (e.g., food refusal )

˙social, emotional, and environmental issues (
進食時,不佳的親子互動)

Results or long-term effects for a child diagnosed with pediatric dysphagia include
  • poor weight gain velocity and/or under nutrition (體重增加/營養不足-e.g. failure to thrive)
  • aspiration pneumonia and/or compromised pulmonary status(吸入性肺炎/肺部受損
  • food aversion(食物厭惡)
  • oral aversion(口腔厭惡)
  • rumination disorder(反芻症:將已經吞下的食物再次吐出咀嚼然後再吞下)
  • dehydration (脫水)
  • ongoing need for enteral or parenteral nutrition (持續需要由腸內/腸外給予營養)



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