• 제목/요약/키워드: swallowing disorder

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섭식장애가 있는 아동의 연하재활치료 : 체계적 고찰 (Dysphagia Rehabilitation Treatment for Children With Feeding Disorder : A Systemic Review)

  • 전주영;박혜연
    • 대한감각통합치료학회지
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    • 제19권1호
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    • pp.39-53
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    • 2021
  • 목적 : 체계적 문헌고찰을 통해 섭식장애가 있는 아동의 질환에 따른 연하장애를 증상별로 세분화하고 증상에 따른 치료방법을 알아보고자 한다. 연구방법 : 데이터베이스는 PubMed, Medline, CINAHL을 통해 검색하였다. PRISMA, PICOS를 이용하여 연구를 선정하고 체계적 고찰을 시행하였다. 최종적으로 연구에 사용한 문헌은 총 13개로 연구의 질적수준, 질환군, 평가도구, 중재방법, 중재 후 효과에 대해서 분석하였다. 결과 : 총 13편의 연구를 분석한 결과 섭식장애가 있는 아동의 질환군은 자폐스펙트럼장애(Autism Spectrum Disorder; ASD)는 6편(46.15%), 뇌성마비(Cerebral Palsy; CP)는 7편(53.85%)으로 나타났다. 섭식장애 중재를 받은 아동의 연령대는 ASD는 2-8세, CP는 12개월-18세까지로 확인하였다. 평가영역에서 ASD는 행동평가, CP는 구강과 삼킴기능 평가영역이 가장 많았다. 중재방법에서 ASD는 행동수정이 가장 많았고, CP는 구강감각운동, 음식질감조절, 전기자극치료가 각각 동일한 빈도로 적용된 것으로 나타났다. 중재 후 치료효과에서는 모두 효과가 있었다. 결론 : 본 연구에서 섭식장애가 있는 아동의 질환군, 적용되는 평가도구, 중재방법을 고찰을 통해 알아보았다. 본 연구가 질환에 따른 평가와 중재 선택 시 임상가들이 시행착오를 거치지 않고 효율적인 섭식장애 중재를 적용할 수 있는 프로토콜 개발을 하는데 기초자료로 활용될 수 있을 것으로 기대한다.

근무력증의 외과적 치료에 대한 임상적 고찰 (Surgical Management of Myasthenia Gravis)

  • 김주현
    • Journal of Chest Surgery
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    • 제13권3호
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    • pp.301-305
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    • 1980
  • Myasthenia gravis is a disorder that affects neuromuscular transmission in a way that is still poorly understood. some think that myasthenia gravis results from a reduction of available acetylcholine receptors in neuromuscular junctions, consequent to some form of autoimmune injury. Surgical interest in this disease was first aroused in 1939 when Blalock observed that some patients with thymic tumors and myasthenia gravis improved following thymectomy. This report represents two cases of myasthenia gravis. The 14-year-old girl was admitted to Korea Universtiy Hospital with chief complaintment of bilateral ptosis, diplopia, swallowing difficulty, and mastication difficulty, which were relieved by administration of edrophonium (Tensilon) chloride, given intravenously. Myasthenica gravis was confirmed and thymectomy was given. After thymectomy, symptoms were relieved but the administration of neostigmine was contijued to be needed till following 3 months. After that period, she was free from this symptoms without anticholinesterase drugs. Second case is 57 year old male who has the symptoms of diplopia, bilatreal ptosis, walking disturbance, and speech difficulty. He had thymectomy too but in thymic tissue, malignant thymoma was included. He has subjective improvement only, with no major reduction of medication requirements after thymectomy.

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흉선절제에 의한 근무력증 치료 2례 보고 (Thymectomy in Myasthenia Gravis: 2 cases report)

  • 이길노
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.490-494
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    • 1980
  • Myasthenia gravis is a neuromuscular disorder manifested by fatigability and weakness of voluntary muscles. The basic defect in the myasthenia is reduction of available acetylcholine receptors at neuromuscuiar junctions by an autoimmune attack. Removal of the thymus gland now play an Important role in the management of this disease. We have two experiences of thymectomy for myasthenic patients. The 31-year-old housewife(J.H) was admitted to the Taegu Presbyterian Medical Center because of bilateral ptosis, mastication and swallowing difficulties. The presence of thymoma was strongly suggested by roentgenographic studies. A 99.8 gm thymoma was removed completely by total thymectomy. On the 2nd postoperative day respiratory failure developed. Tracheostomy was performed and ventilatory assist was given for 3 days. The patient was completely recovered with antichollestrase drug only. C.N. was 17-year-old girl who has the symptoms of bilateral ptosis and diplopia for 3 years. Tensilon test was positive and antichollnestrase was given for several months, but the patient showed no improvement. After thymectomy she was free from myasthenic symptoms with out anticholinestrase drug.

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후두초음파의 임상적 활용 (Practical Approach of Laryngeal Ultrasonography)

  • 조우진
    • 대한후두음성언어의학회지
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    • 제29권1호
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    • pp.19-23
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    • 2018
  • Ultrasonography has increasingly moved from being a modality confined to the radiology department to an active diagnostic and therapeutic aid available to the head and neck at the point of patient care. However, the application of ultrasonography to the laryngeal disorder is very rare due to progressive age-related ossification of laryngeal cartilage and the presence of air in the lumen, which contribute to difficult conditions for transmission of the ultrasonic waves. The observation about the movements of larynx or surrounding structures is important to understand the physiology of phonation or swallowing and to diagnose the disease. Ultrasonography is a noninvasive and safe imaging technique that can be used to investigate the anatomic structures of the head and neck. Recently, the development of high-frequency ultrasonography makes it possible to apply the ultrasound in the evaluation of larynx.

후두운동장애 (Movement Disorders Affecting the Larynx)

  • 권택균;손희영
    • 대한후두음성언어의학회지
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    • 제21권1호
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    • pp.22-26
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    • 2010
  • Neuromuscular Disorders Affecting the Larynx are steadily important topics at laryngology. Physiology of larynx is controlled by the frame structure and neuromuscular dynamics to acting on the specialized soft tissue, Therefore, for a proper understanding of the larynx, it is needed the voice and swallowing, a series of prayers on the regulation of neurologic function and the correlation between systemic neuromuscular disease and laryngeal symptoms and clinical knowledge, We described that clinical findings and treatments of the 3 neurological diseases causing dysphonia well (Parkinson's disease, laryngeal tremor, spasmodic dysphonia) and vocal impairments for stoke patients.

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치과의사 맞춤형 마우스가드의 제작방법 (Understanding and Practice of Eating-Swallowing Disorder)

  • 노관태
    • 대한치과의사협회지
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    • 제56권6호
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    • pp.333-338
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    • 2018
  • The mouth guard is a device with elasticity to be installed in the oral cavity. It has a function to reduce the trauma in the oral cavity and to protect the teeth and surrounding tissues from trauma. The purpose of mouth guard is to prevent trauma and concussion. It is mandatory to wear a mouthguard in sports where there is a lot of contact and the possibility of trauma or concussion in the mouth area is high. The mouse guard is divided into a stock type, a mouth formed type, and a custom made type according to the manufacturing method. The custom made type is made on the individual dentition model and has excellent retention because of its excellent fit. Also, the effect of trauma prevention is excellent. It is possible to design and adjust by the dentist and reduce the complaint the athlete has about the mouthguard. In this article, the process of making a dentist-customized mouthguard was described.

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구강안면운동장애에 대한 필로카핀의 적용 (The Effects of Pilocarpine in Patients with Orofacial Movement Disorder)

  • 정성희;옥수민;허준영;고명연;안용우
    • Journal of Oral Medicine and Pain
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    • 제37권2호
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    • pp.107-112
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    • 2012
  • 하악 및 구강주위근육의 조절되지 않는 움직임으로 정의 되는 구강안면운동장애(orofacial movement disorder, OMD)는 노인층에서 많이 발생하며 그 원인이 아직 정확히 밝혀지지 않고 치료방법 또한 다양하다. 임상적 특징을 분석하고 치료방법을 연구한 자료는 많이 있으나 타액분비와 OMD의 상관관계에 대한 구체적인 연구는 아직 없다. 본 연구에서는 부산대학교치과병원 구강내과에 내원한 OMD 환자 중 구강건조감을 호소한 4명의 환자를 증례로 하여 필로카핀(pilocarpine)을 경구로 투여한 후 OMD 증상의 변화를 관찰하였다. 연구결과 타액분비량의 저하를 보여 구강건조증으로 진단된 증례와 정상타액분비량을 보이는 증례 모두에서 필로카핀의 경구투여 후 OMD증상의 개선을 보였다. 따라서 향후 OMD와 구강건조증의 상관관계에 대한 추가적인 연구가 필요할 것으로 사료된다.

연하장애 환자의 삶의 질 영향 요인 (Factors Influencing Swallowing-related Quality of Life in Patients with Dysphagia)

  • 김주연
    • 한국산학기술학회논문지
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    • 제17권11호
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    • pp.421-431
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    • 2016
  • 본 연구는 연하장애 환자의 삶의 질 향상을 목적으로 연하장애 환자의 우울, 사회적 고립감, 생의 의미와 삶의 질수준을 파악하고, 삶의 질의 영향요인을 확인하고자 시도되었다. 연구대상은 서울, 인천, 경기 지역에 소재한 종합병원과 재활병원 등 8개 기관에서 뇌졸중, 퇴행성 신경계 질환으로 인하여 연하장애가 발생한 환자 총87명을 대상으로 하였다. 자료수집기간은 2015년 2월부터 4월까지였으며, 연구도구는 CES-D, RULS, PIL, SWAL-QOL을 사용하였다. 수집된 자료는 SPSS 22.0 통계프로그램을 이용하여 기술통계, t-test, ANOVA, Pearson's correlation, Stepwise multiple regression으로 분석하였다. 연구 결과 우울이 있는 군은 대상자의 20.7%였고, 보통 이상의 사회적 고립감을 느끼는 군 92.0%, 실존적 공허상태에 있는 군이 64.4% 였다. 즉, 대다수의 대상자들이 사회적 고립감을 경험하고 실존적 공허상태에 있었으며, 삶의 질의 평균 점수는 158.89(35.97)점이었다. 연하장애 환자의 삶의 질 영향요인을 확인한 결과, 경관급식의 경우가 정상식이보다 삶의 질이 유의하게 낮았고(${\beta}=-0.57$, p<.001), 생의 의미가 낮아 실존적 공허상태에 있는 경우(${\beta}=0.19$ p=.014)가 삶의 질이 낮았다. 30-49세의 연령은 80세 이상보다 삶의 질이 높았으며(${\beta}=0.26$, p=.001), 대학교 수준 이상의 교육수준이 무학에 비해 삶의 질이 높았다(${\beta}=0.17$, p=.032). 이 중 연하장애 환자의 삶의 질에 가장 많은 영향을 주는 변수는 경관급식이었고 (${\beta}=-0.57$, p<.001), 이러한 4개의 변수는 연하장애 환자의 삶의 질에 대해 50.7%(F=28.84 p=.031)의 설명력을 나타냈다. 그러므로 연하장애 환자의 삶의 질을 높이기 위해 생의 의미를 높일 수 있는 중재 프로그램의 개발과 함께, 경관급식 환자의 삶의 질이나 정서 상태를 확인할 수 있는 후속연구가 필요하다.

중증 근무력증의 외과적 치료 (Surgical Treatment of Myasthenia Gravis)

  • 손영상
    • Journal of Chest Surgery
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    • 제21권3호
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    • pp.454-461
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    • 1988
  • Myasthenia gravis is a functional neuromuscular disorder with characteristic voluntary muscle weakness. The role of thymus in pathogenesis of this disorder has become apparent that thymectomy in treatment has gained acceptance. Between January 1976 and June 1987, twenty patients underwent thymectomy for myasthenia gravis at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University. A clinical study that is focused on the factors affecting the operative results was analyzed and the following results were obtained. Among the 20 patients, male to female ratio was 8:12 and the age of onset was ranged from 3 years to 67 years. The chief complaints in order of frequency were as follows; ocular symptoms such as ptosis and diplopia[7 cases], general weakness[4 cases], swallowing difficulty[3 cases], dyspnea[3 cases], dysphasia[1 case], headache[1 case] and dizziness[1 case]. The severity of disease was classified by modified Osserman`s method that Group IIa was 8 cases, Group IIb; 7 cases, Group IIc; 3 cases and Group I; 2 cases. In histopathology of thymus, the most frequent finding was hyperplasia[11 cases] followed by thymoma[4 cases], normal tissue[3 cases] and malignant` thymoma[2 cases]. There were two cases of postoperative complications; one case was wound infection and the other was mediastinitis. One case of malignant thymoma died due to respiratory failure with pulmonary metastasis. There was 16 cases[80%] of improvement after thymectomy as follows; complete remission was 4 cases[20%], marked improvement was 9 cases[45%] and subjective improvement only was 3 cases[15%]. The effect of severity and duration of disease on operative result has statistically significant. The effect of thymus histopathology on operative result was not statistically significant. But there were comparable results between thymoma cases and non-thymoma cases.

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각성조절과 빨기/삼키기/숨쉬기의 조화(Suck/Swallow/Breathe Synchrony)와의 연관성에 관한 고찰 (The Literature Review on the Relation between the Modulation of Arousal and the Suck/Swallow/Breathe(SSB) Synchrony)

  • 김인선;이지영;황지영
    • 대한감각통합치료학회지
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    • 제1권1호
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    • pp.61-72
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    • 2003
  • The suck/swallow/breathe(SSB) synchrony, serving as the earlist primary motor mechanism, is the rhythmical, coordinated pattern of sucking, swallowing and breathing. The development of an intact SSB is an important precursor for further sensorimotor and cognitive development including speech and language development, state regulation, postural control, feeding, eye/hand coordination and social/emotional development. Arousal means a neurological mechanism for preparing one's body to orienting stimulus. Its levels are regulated with an interaction of the reticular formation, the limbic system, the hypothalamus and the autonomic nervous system. General strategies such as blowing, sucking, chewing, munching and licking to effectively modulate arousal state are related to SSB. The SSB synchrony is an important treatment principle for children with sensory integration disorder and problems with the modulation of arousal. The purpose of this article is to review concepts of SSB synchrony and the underlying relation between the modulation of arousal and SSB synchrony.

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