老年人的吞咽困难

Asaad G Ishak, S. Cherukuri, Giancarlo Diaz, R. McCallum
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引用次数: 3

摘要

吞咽困难是一种常见的情况,尤其是在老年人中,可能会使人虚弱。随着年龄的增长,食道运动有细微的变化,但绝不是吞咽困难被认为是衰老的正常结果。吞咽困难通常伴有多种症状,从吃饭时反胃、轻度不适到严重的胸痛。从病史中定位吞咽困难是很有挑战性的。潜在的病因可能在随后的调查中变得明显。能够诊断吞咽困难是至关重要的,因为早期发现与降低发病率和某些情况下的死亡率有关。此外,通过临床怀疑、确认性影像学或内镜评估进行早期发现是很重要的,因为它可以根据潜在的病因进行早期干预和适当的管理,从而产生经济效益和降低医疗成本。吞咽困难有多种原因,大多数是良性的,但医生应该时刻注意可能是更严重原因的危险信号,比如潜在的恶性肿瘤。在这篇综述文章中,我们的目标是关注吞咽困难的临床症状的检测,并回顾适当的进一步评估和更新对这一潜在严重疾病的管理,以使老年患者获得最佳的生活质量。
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Dysphagia in the Older Age Setting
Dysphagia, or difficulty swallowing, is a common condition, especially among the elderly population and can become debilitating. As we age, there are subtle changes in esophageal motility, but by no means is dysphagia ever considered to be a normal result of aging. Dysphagia usually presents with a variety of accompanying symptoms ranging from regurgitation during meals, mild discomfort, to severe chest pain. It can be challenging to localize the dysphagia from the history. The underlying etiology may become evident during subsequent investigations. It is essential to be able diagnose dysphagia as early detection is associated with decreased morbidity and in some cases mortality. In addition, early detection through clinical suspicion, confirmatory imaging or endoscopic evaluation is important as it can lead to early intervention with proper management depending on the underlying etiology, resulting in economic benefit and reduced medical costs. There are various causes of dysphagia, with the majority being benign, but a physician should always be aware of red flags present which may signal more serious causes, such as an underlying malignancy. Our goal in this review article is to focus on detecting the clinical signs of dysphagia and review appropriate further evaluation and update on management of this potentially serious condition in order for elderly patients to achieve an optimal quality of life.
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