• Title/Summary/Keyword: 연하 곤란

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Development and Utilization of Assessment and Intervention Checklist for Post-stroke Dysphagia (뇌졸중 후 연하곤란 사정과 중재 체크리스트 개발 및 활용정도)

  • Lee, Eun Ha;Choi, Ja Yun
    • Korean Journal of Adult Nursing
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    • v.25 no.2
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    • pp.113-124
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    • 2013
  • Purpose: Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization. Methods: The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients. Results: A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia. Conclusion: We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.

Congenital Esophageal Stenosis due to Tracheobronchial Remnants -1 case report- (기관기관지 잔유조직에 의한 선천성 식도협착 -1례 보고-)

  • 이선희;권종범
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.248-250
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    • 1996
  • Congenital esophageal stenosis due to tracheobronchial remnant is very rare disease entity and usually occurs in mid and lower esophagus. The cause is esophageal sequestration of a tracheobronchial anlage before embryologic separation. A 4 years old girl was admitted with swallowing difficulty, food regurgitation which progressively got worse in recent 2 years. She was operated under the dagnosis of achalasia. During the myoto y procedure we found the bean sized hard nodular mass, which was 4cm above the esophagogastric junction, and after the resection of mass, esophagoplasty was carried out. The histologic finding of the mass revealed traheal cartilages and respiratory glands.

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A Case of Oropharyngeal Neurilemmoma with Swallowing Difficulty. (연하곤란을 초래한 구인두부 신경초종 1례)

  • 심상열;양오규;백석인;윤강묵;박순일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.11.1-11
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    • 1981
  • Neurilemmoma is a benign tumor which arises generally from the Schwann's cells. It is a slowly growing tumor and treated as surgically. We experienced a case of neurilemmoma of the oropharynx in a 28-year-old female who had noticed a gradual swelling of the left side of the oropharynx with swallowing difficulty for 6 months. The tumor was removed successfully intra-orally under the general endotracheal anesthesia and verified pathologically as neurilemmoma.

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Development and Evaluation of a Dysphagia Nursing Intervention Program for Patients with a Stroke (뇌졸중 환자에게 제공한 연하곤란 간호중재 프로그램 효과)

  • Song, Young Ae;Beom, Ji Hyun;Ham, Young Sun;Kim, Sang Hee
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.340-348
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    • 2011
  • Purpose: The purpose of this study was to develop and provide a standardized nursing intervention program for stroke patients with dysphagia and evaluate the effectiveness of the program. Methods: Data on the number of tube feedings, incidence of aspiration pneumonia and length of stay were collected from 42 patients in the control group and 51 patients in the experimental group over the 6 months of this study. The data were analyzed using $x^2$-test and t-test. Results: The number of tube feedings in the experimental group was significantly lower than control group (p=.002). The incidence of aspiration pneumonia in the experimental group was not significantly lower than the control group (p=.097). Length of stay in the experimental group was significantly shorter than the control group (p<.001). Conclusion: The results of this study indicate that a standardized nursing intervention program for stroke patients with dysphagia could be useful to decrease tube feedings and length of stay.

Alveoloar Rhabdomyosarcoma of Tongue Base in an Infant : A Case Report (영아의 설근부에 발생한 폐포성 횡문근육종 1예)

  • Kim, Jisung;Yeon, Je Yeob;Park, Jae-Hong;Lee, Yong-Moon;Lee, Dong Wook
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.75-78
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    • 2013
  • 영아의 설근부에 발생하는 악성 종양은 매우 드물다. 저자들은 연하곤란과 폐쇄성 수면 무호흡증으로 의뢰된 17개월 남아의 설근부에 발생한 횡문근육종을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 외래에서 실시한 이학적 검사 상 설근부 전체가 돌출되어 있었으며 단단한 종괴가 촉지 되었다. 조직검사와 기관절개술을 시행하였으며 컴퓨터단층촬영, 양전자 방출 단층 촬영 그리고 뼈 스캔과 함께 염색체 분석을 실시하였다. 조직검사 결과 폐포성 횡문근육종이 확인되었으며 전이의 증거는 없었다. 염색체 분석상 폐포성 횡문근육종에 상응하는 PAX7-FKHR 유전자 전좌가 발견되었다. 8 회의 항암화학요법과 방사선 치료 후 촉지되는 설근부의 종괴는 없었으며 환자가 호소하는 증상도 개선되었다. 추적 관찰 시 시행된 자기공명영상 결과 확연한 종괴 크기의 감소를 확인할 수 있었다. 횡문근육종은 매우 드문 악성 종양으로 수술과 함께 항암화학요법, 방사선치료 등 여러 치료 방법이 동원되지만 전이나 재발이 있을 시 예후는 매우 불량하다. 그러므로 영아에서 연하곤란, 호흡 곤란 등의 증상이 있을 시에는 설근부를 포함한 상부호흡소화관을 적극적으로 검사하여야 하며 악성 종양의 가능성을 염두에 두어야 하겠다.

A rare case of esophageal foreign body complicating mediastinitis, pulmonary atelectasis, and daeth (식도이물 사망례)

  • 배정보;조승호;강주원;김병우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.90.4-90
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    • 1976
  • Foreign bodies of the esophagus are frequently seen in otolaryngological fields and there are numerous reports about the cases of esophageal foreign bodies in the literatures. It is well known and agreed to most of the authors that the most common subjects of foreign bodies in the esophagus are coins in young children. The authors recently experienced a rare case of foreign body in the first narrowing of the esophagus in a l-year-old female who visited with the complaints of fever, dysphagia and imspiratory dyspnea for 5 days, complicating subcutaneous emphysema, periesophageal abscess, mediastinal emphysema, mediastinitis and lung atelectasis causing death.

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Prevalence and associated factors of dysphagia in patients hospitalized with acute stroke (급성 뇌졸중 입원 환자의 연하장애 유병률과 관련요인)

  • Chang, Hee-Kyung;Yun, Suk-Kyung;Gil, Cho-Rong
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.1
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    • pp.417-428
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    • 2019
  • The aims of this study were to evaluate the prevalence of dysphagia in patients hospitalized with acute stroke and to identify factors associated with dysphagia. The study was conducted in a tertiary hospital and a total of 131 patients hospitalized with acute stroke (aged 34-92 years old, 58.0% male) were enrolled. The prevalence of dysphagia was 24.4% out of 131 participants and risk factors associated with dysphagia were age, neurological severity, oral health status, and dependence in activity of daily living of participants. Considering the long-term rehabilitation trajectory, it is necessary to apply the early screening and preventive nursing intervention for dysphagia during acute stage of stroke patient.

A Case of Cricopharyngeal Dysphagia Treated by Botulinum Toxin Injection (보톡스 주입술로 치료된 윤상인두 연하장애 1예)

  • Choi, Kyu-Young;Rho, Young-Soo;Lee, Dong-Jin;Chung, Eun-Jae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.52-55
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    • 2011
  • Hyperfunction of the upper esophageal sphincter (UES) can cause severe dysphagia. This condition referred as cricopharyngeal dysphagia may occur after head and neck surgery due to altered muscle spasm and stenosis of the pharyngo-esophageal segment. Among various treatment options available, Botulinum toxin A (Botox) injection offers a nonsurgical treatment which is useful especially for debilitated patients, and there has been a recent increase in the clinical use of Botox by otolaryngologists for managing such conditions. A 55-year-old male with base of tongue (BOT) cancer suffered from severe dysphagia after total glossectomy and neck dissection treatment. Videofluoroscopic swallow study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) showed inability to pass food through the UES due to cricopharyngeal spasm. After injection of 10 U of Bot ox into each cricopharyngeus muscles (total 20 U) via EMG-guided percutaneous injection, swallowing function had improved and oral nutrition was possible, with food passing through the UES visualized on VFSS and FEES.

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방위산업의 새 진로-기술개발 촉진으로

  • Min, Seong-Gi
    • Defense and Technology
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    • no.6 s.172
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    • pp.18-20
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    • 1993
  • 과학기술 전전 7개국 진입을 뒷받침하기 위한 산.학.연의 역할 분담과 협력의 필요성이 더욱 증대되는 가운데 21세기 국가안보는 방산기술 개발만으로 보장이 가능한 상황입니다. 그러나 향후 신군사력 건설을 위한 추가투자없이 재래식병기수요만으로는 기존에 조성된 방위산업 기반도 유지하기가 곤란한 실정입니다. 방산기술 개발 투자확대의 필요성으로 주변국의 위협으로부터 국가생존권 확보를 위한 핵심전력 개발 및 주전투장비의 지속적인 성능 개량이 요구됩니다. 이와 함께 방산참여자의 "우리도 할수 있다"는 신념 회복이 절실히 요구되는 때입니다

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An Evaluation of Usefulness of FEES Method using Full HD Video that Improves Diagnostic Value of VFSS (Full HD 동영상을 이용한 FEES법이 VFSS의 진단적 가치를 향상 시키는 유용성에 대한 평가)

  • Kim, Young-Ran;Kim, Young-Il
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.678-685
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    • 2016
  • Deglutition inspection has been the gold standard for inspection of dysphagia using a penetration device of the division of radiology to date. However, inspection using an endoscope has facilitated diagnosis of dysphagia in recent days. In this study, we compared the results of VFSS alone with those of VFSS combined with FEES to determine if the detection rate of penetration, aspiration, and pharyngeal residue increased. This study evaluated at 130 persons who underwent both VFSS and FEES from December 2013 through March 2014, and used VFSS (FELAVISION, SHIMADZU) and FESS (EVIU LUCERA CV-260SL, OLYMPUS) as devices. After preparing barium diluted solution, yogurt that diluted barium and rice that diluted barium in 2.5 ml, 5 ml, 10 ml by modifying Logemann's protocol in part, and having subjects take the solution, this study confirmed pharyngeal residue, penetration, aspiration etc. VFFS and FEES using full HD video revealed aspiration in 36 of the 130 patients in both inspections. Additionally, aspiration was discovered in 36 patients upon VFFS, but in 41 upon FESS. Although FEES was more sensitive at diagnosing dysphagia, the two inspection methods are complementary, so diagnostic value will be greatly improved when the endoscope operating method and accurate fluoroscopic inspection are combined.