新冠肺炎疫情下咀嚼吞嚥障礙之照護策略

Strategies of Swallowing Care during COVID-19 Pandemics

林政宜(Cheng-Yi Lin) ； 璩大成(DaChen Chu) ； 黃勝堅(Sheng-Jean Huang) ； 李雅玲(Ya-Ling Li)

《北市醫學雜誌》 預刊文章 Pp. 1-7

https://doi.org/10.6200/TCMJ.202010/PP.0027

摘要

全球新冠肺炎疫情嚴峻，未來可能面對第二甚至第三波疫情，甚至成為無法完全回復的新常態（new normal）。臨床醫療人員需思考在新冠肺炎疫情期間，如何藉由照護策略調整降低感染風險，甚至疫情驟變時COVID-19病患拔管後吞嚥困難之人數大量增加的解決之道。吞嚥困難評估及訓練經常牽涉許多口咽部肌肉活動，刺激病患咳嗽、打噴嚏產生飛沫顆粒。考量空氣傳染為新冠肺炎病毒有可能的傳播途徑及無症狀者超級傳播事件的風險，本文嘗試以目前研究證據探討新冠肺炎患者所產生的咀嚼吞嚥障礙風險，與吞嚥整合照護在疫情下所遭遇的限制及相關照護策略。

關鍵字

新冠肺炎 ； 咀嚼吞嚥障礙

並列摘要

The COVID-19 pandemic is harsh, and a second- or a third-wave attack may occur, and even more, become a nonrecoverable new normal. Medical professionals should consider reducing the infection risk by adjusting care strategy and, even more, the solutions of caring for many patients after extubation during the sudden change of pandemic conditions. The assessment of swallowing difficulty and training commonly involve oropharynx muscle activity, stimulating cough, and droplets production from the coughs. Considering the risk of airborne transmission of the new coronavirus and the events of super transmission of the non-symptomatic carriers, this article attempts to explore the risk of chewing and swallowing difficulty in patients infected with the new coronavirus infection based on current evidence and dysphagia integrated care under the limitations of the pandemics and related care strategy.

並列關鍵字

COVID-19 ； dysphagia ； swallowing care