全文获取类型
收费全文 | 88篇 |
免费 | 11篇 |
专业分类
耳鼻咽喉 | 6篇 |
儿科学 | 1篇 |
基础医学 | 2篇 |
口腔科学 | 2篇 |
临床医学 | 16篇 |
内科学 | 56篇 |
神经病学 | 2篇 |
特种医学 | 9篇 |
外科学 | 4篇 |
肿瘤学 | 1篇 |
出版年
2023年 | 3篇 |
2021年 | 3篇 |
2020年 | 2篇 |
2019年 | 4篇 |
2018年 | 1篇 |
2016年 | 3篇 |
2015年 | 2篇 |
2014年 | 2篇 |
2013年 | 1篇 |
2012年 | 1篇 |
2011年 | 2篇 |
2010年 | 1篇 |
2009年 | 5篇 |
2008年 | 4篇 |
2007年 | 4篇 |
2006年 | 5篇 |
2005年 | 3篇 |
2004年 | 6篇 |
2003年 | 3篇 |
2002年 | 2篇 |
2001年 | 1篇 |
2000年 | 3篇 |
1999年 | 2篇 |
1998年 | 10篇 |
1997年 | 3篇 |
1994年 | 2篇 |
1993年 | 6篇 |
1992年 | 4篇 |
1991年 | 1篇 |
1990年 | 2篇 |
1989年 | 4篇 |
1988年 | 3篇 |
1987年 | 1篇 |
排序方式: 共有99条查询结果,搜索用时 31 毫秒
71.
The Effect of Compliance on Clinical Outcomes for Patients with Dysphagia on Videofluoroscopy 总被引:1,自引:0,他引:1
This study investigates clinical outcomes and the degree of compliance in patients who received advice on dysphagia management
and the effect of the level of compliance on the incidence of chest infections and aspiration pneumonia, cause of death, and
hospital readmission. We performed a retrospective cohort study of 140 patients who had videofluoroscopic studies at Princess
Margaret Hospital, Christchurch, New Zealand, from 1 January 1996 to 30 June 1997. The degree to which recommendations on
dysphagia management were followed was correlated with the incidence of chest infections, aspiration pneumonia, and readmissions
to the hospital. Cause of death, including the contribution of aspiration pneumonia, was assessed by review of medical records
and death certificates. Information was available for 89% of the cohort. Twenty-one percent of the survivors never complied
with the advice given. Noncompliant subjects were younger (p<0.05) and more likely to be living at home rather than receiving institutional care (p=0.05). Noncompliers had more hospital admissions because of chest infections or aspiration pneumonia (22% vs. 1.5%; p<0.001). Home-dwelling noncompliant subjects received more courses of antibiotics (p<0.02), but there was no difference in the number of chest infections. Fifty-four people died during the study period. Aspiration
pneumonia was recorded as a definite or probable cause of death in 26 (52%) of the 50 subjects for whom reliable information
was available and in 6 of 7 subjects who made a deliberate and documented decision not to comply. We conclude that noncompliance
with recommendations about dysphagia management is associated with adverse outcomes. There was a high mortality rate and aspiration
pneumonia was a common cause of death.
Submitted October 4, 1999; accepted September 15, 2000 with revision 相似文献
72.
The factors associated with tube feeding dependency in stroke patients with dysphagia have received little attention. This
study aimed to identify factors independently associated with tube feeding dependency at discharge in stroke patients with
dysphagia using videofluoroscopic swallowing studies (VSS) and clinical findings. One hundred eighty-one consecutive tube-fed
inpatients with stroke-related dysphagia referred for VSS were enrolled in the study. Of them, 47 patients continued to require
tube feeding at discharge. In the final logistic regression analysis model, advanced age, recurrent stroke, confinement to
a wheelchair at discharge, long duration from stroke onset to VSS, and stasis in valleculae or pyriform sinuses and aspiration
on VSS were independently associated with tube feeding dependency at discharge. This study confirms the association between
findings of VSS and tube feeding dependency at discharge in stroke patients with dysphagia. Based on the final regression
model, a preliminary equation was proposed to help clinicians better predict the tube feeding dependency at discharge in stroke
patients with dysphagia.
An erratum to this article is available at . 相似文献
73.
Videofluoroscopic evaluation of the swallowing function after supracricoid laryngectomy 总被引:1,自引:0,他引:1
Ali?Vefa?YücetürkEmail author Serdar?Tarhan K?van??Günhan Yüksel?Pabu??u 《European archives of oto-rhino-laryngology》2005,262(3):198-203
This study was designed to evaluate the swallowing function in patients with supracricoid laryngectomy (SCL) compared to normal subjects and to search for the factors affecting postoperative aspiration. Ten patients who underwent SCL with cricohyoidopexy (CHP) for primary laryngeal squamous cell carcinoma were included in the study. The control group consisted of 13 normal adult volunteer men with similar ages. The swallowing act of the subjects was evaluated by using videofluoroscopy (VFS) and videolaryngostroboscopy (VLS). The movements of the larynx were measured with regard to the hyoid bone, mandible and vertebral spine. The patients with SCL-CHP, except for two who had slight aspiration, had effective and near normal swallowing regarding the measurements of the movements of the hyoid bone. They could tolerate a near-normal oral diet. We have observed that the preventive precautions for aspiration are preserving the superior laryngeal nerves, suturing and positioning the cricoarytenoid unit as anterosuperiorly as possible, early decannulation and early onset of swallowing rehabilitation; the risk factors for aspiration are advanced stage of cancer, postoperative radiation and shortening of bolus transit time. VFS is useful for the patients with postoperative aspiration, because it is the definitive technique for anatomical and physiological evaluation of swallowing. We consider that the parameters of VLS and VFS, such as tongue base-arytenoid contact, presence of bolus splitting, pseudoepiglottis function, maximal opening of the pharyngoeosophageal sphincter and total movement of hyoid bone are important criteria to evaluate swallowing. 相似文献
74.
A protocol for the videofluorographic swallowing study 总被引:4,自引:0,他引:4
Jeffrey B. Palmer MD Keith V. Kuhlemeier PhD Donna C. Tippett MA C. Lynch MS 《Dysphagia》1993,8(3):209-214
75.
Abstract
The overall objective of this pilot study was to determine blue dye test reliability and validity for the identification of
aspiration of secretions, food, and/or drink in 50 simultaneously administered blue dye (BDT) and modified barium swallow
(MBS) tests of tracheostomized individuals. With the MBS as an objective test of aspiration, BDT sensitivity and specificity
identifying aspiration were less than 80% and 62%, respectively. Certain tracheostomy tube conditions and food consistencies
were associated with more accurate BDT aspiration results than others. Characteristics of the aspiration episodes, interpretation
of the results, and needs for further research are discussed. 相似文献
76.
Maurizio Giovanni Vigili Anna Cristina Colacci Marta Magrini Paola Cerro Andrea Marzetti 《European archives of oto-rhino-laryngology》2002,259(1):11-16
Assessment of quality of life (QoL) and satisfaction with care are particularly important in the field of oncology. The definition
of QoL and the requirements for its measurement are still a matter of debate, but it is generally accepted that QoL is a multidimensional
concept involving three different domains: physical, psychological and social. The aim of this study was to test a simple,
inexpensive, multidimensional method of QoL measurement, based both on patients’ perception of clinical outcome and the quantitatively
evaluated clinical outcome, equally weighted, in patients who underwent three different types of conservative laryngeal surgery:
horizontal laryngectomy (HG), supraglottic laryngectomy (SL) and subtotal reconstructive laryngectomy (SRL). The following
were carried out for each patient: subjective-objective evaluation of speech [computerized spectrographic analysis of fundamental
frequency (F0), percentage of noise and intensity and logopedic evaluation of speech], evaluation of deglutition (videofluoroscopic
parameters, and qualitative assessment) and evaluation of physical, social, emotional and functional well-being (Functional
Assessment of Cancer Therapy, FACT-G, and modified University of Washington Quality of life Scale, UWQoL). Each assessment
was given a score rating from one to three points. The overall evaluation of the qualitative and quantitative score for each
field and for each type of laryngeal surgery shows that SL results in the best post-operative QoL. Although HG is less damaging
and involves swifter functional recovery times, its slightly lower score is due to the poorer quality of speech. The analysis
of the results obtained confirm the need to set up an evaluation protocol combining both the subjective perceptions of the
patient, as well as the more objective evaluation of the functions that are impaired following surgery. The protocol described
above, although limited by the low number of cases, was easy to carry out, inexpensive and applicable in relation to the various
types of surgery that may compromise phonation and deglutition.
Received: 23 February 2001 / Accepted: 13 August 2001 相似文献
77.
The aim of this study was to identify the origin of swallowing sound components by using modern techniques that can provide numeric, synchronized acoustic-radiologic data. We enrolled 15 volunteer subjects (10 men and 5 women, average age = 29.5 +/- 8 years) and used an X-ray camera connected to a video acquisition card to obtain synchronized acoustic-radiologic data (25 images/s). The subjects were asked to swallow 10 ml of a barium suspension. Each sound component was associated with a specific position of the bolus and the anatomic structure that was moving. The average duration of the pharyngeal sound was 690 +/- 162 ms. The durations of the laryngeal ascension sound and the laryngeal release sound were significantly different (72 +/- 38 ms and 106 +/- 47 ms, p < 0.001). The upper-sphincter opening sound was present in 100% of the recordings. Its duration was 185 +/- 103 ms and was significantly different from the two other sounds. The duration of the first interval was 108 +/- 44 ms and the duration of the second was 236 +/- 139 ms. This study allowed us to determine the origin of the three main sound components of the pharyngeal swallowing sound with respect to movements in anatomic structures and the different bolus positions. 相似文献
78.
Martin-Harris B Brodsky MB Michel Y Castell DO Schleicher M Sandidge J Maxwell R Blair J 《Dysphagia》2008,23(4):392-405
The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment (p < or = 0.05). Factor analysis revealed 13 significant components (loadings >/= 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS. 相似文献
79.
Logemann JA Rademaker A Pauloski BR Antinoja J Bacon M Bernstein M Gaziano J Grande B Kelchner L Kelly A Klaben B Lundy D Newman L Santa D Stachowiak L Stangl-McBreen C Atkinson C Bassani H Czapla M Farquharson J Larsen K Lewis V Logan H Nitschke T Veis S 《Dysphagia》2008,23(4):378-384
There is little evidence regarding the type(s) of information clinicians use to make the recommendation for oral or nonoral
feeding in patients with oropharyngeal dysphagia. This study represents a first step toward identifying data used by clinicians
to make this recommendation and how clinical experience may affect the recommendation. Thirteen variables were considered
critical in making the oral vs. nonoral decision by the 23 clinicians working in dysphagia. These variables were then used
by the clinicians to independently recommend oral vs. nonoral feeding or partial oral with nonoral feeding for the 20 anonymous
patients whose modified barium swallows were sent on a videotape to each clinician. Clinicians also received data on the 13
variables for each patient. Results of clinician agreement on the recommendation of full oral and nonoral only were quite
high, as measured by Kappa statistics. In an analysis of which of the 13 criteria clinicians used in making their recommendations,
amount of aspiration was the criterion with the highest frequency. Recommendations for use of postures and maneuvers and the
effect of clinician experience on these choices were also analyzed.
相似文献
Jeri A. LogemannEmail: |
80.
目的 观察不同时间肌电生物反馈治疗(EMGBF)对脑卒中后吞咽障碍患者吞咽功能及舌骨喉复合体运动速率的影响。 方法 选取我院42例脑卒中后咽期吞咽功能障碍患者,按照随机数字表法将患者分为常规组(15例)、EMGBF组(14例)和强化EMGBF组(13例)。3组患者均给予神经科常规药物治疗及运动功能康复训练,在此基础上常规组给予常规吞咽功能训练,每日30 min,每周5 d;EMGBF组在常规吞咽功能训练基础上增加1次肌电生物反馈治疗,每日1次,每周5次;强化EMGBF组在常规吞咽功能训练基础上增加2次肌电生物反馈治疗,每日2次,每周10次。所有患者均治疗4周。分别于治疗前、治疗4周后(治疗后),进行吞咽造影检查(VFSS),测量舌骨在吞咽半流质食物时向前、向上的运动幅度、时间,计算运动速率,采用吞咽障碍程度评定、Rosenbek渗透-误吸量表(PAS)对3组患者进行评定。 结果 治疗前,3组患者吞咽障碍程度、PAS评分、舌骨前移运动速度、舌骨上移运动速度比较,差异无统计学意义(P>0.05)。与组内治疗前比较,3组患者治疗后吞咽障碍程度、PAS评分、舌骨前移运动速度、舌骨上移运动速度均有所改善(P<0.05)。治疗后,与常规组比较,EMGBF组和强化EMGBF组吞咽障碍程度评分均较高(P<0.05)、PAS评分较低(P<0.05),强化EMGBF组治疗后吞咽障碍程度评分虽然高于EMGBF组,但差异无统计学意义(P>0.05),强化EMGBF组治疗后PAS评分[(2.38±1.19)分]低于EMGBF组[(3.57±1.45)分],差异有统计学意义(P<0.05)。与常规组治疗后比较,EMGBF组和强化EMGBF组舌骨前移、上移运动速度均较高(P<0.05)。与EMGBF组治疗后比较,强化EMGBF组舌骨前移[(34.10±12.67)mm/s]、上移运动速度[(34.30±9.16)mm/s]较高(P<0.05)。 结论 肌电生物反馈强化训练在改善吞咽障碍患者吞咽功能及提高舌骨喉复合体运动速率方面优于常规吞咽训练及肌电生物反馈训练。 相似文献