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Examination
医学检查
Oral and throat examination should be done, but the main way to assess the dysphagia is to ask the patient to swallow solid food and liquids in front of you.
应进行口腔和咽喉检查，但评估吞咽困难的主要方法是让患者在你面前吞咽固体食物和液体。
Investigations
调查
We shall start with baseline investigations.
我们将从基线调查开始。
Chest X ray can give us a quick and rough idea about the esophagus, but more importantly, it gives an idea about any aspiration pneumonia.
胸部X光片可以让我们对食道有一个快速而粗略的了解，但更重要的是，它可以让我们对任何吸入性肺炎有一个了解。
X ray neck, Antero posterior and lateral view, can give a quick and rough idea about the pharynx, larynx and upper esophagus.
X线颈、前、后及侧位片可以快速、粗略地了解咽部、喉部和食道上部的情况。
If a neck pathology is suspected to cause dysphagia, CT scan or MRI may also be advised.
如果怀疑颈部病变导致吞咽困难，也可以建议进行CT扫描或MRI扫描。
Complete blood count, urea and electrolytes can give an idea about the patient's condition, e.g. does he/she have any electrolyte disturbance due to dehydration.
全血细胞计数、尿素和电解质可以了解病人的情况，例如，他/她是否因脱水而出现电解质紊乱。
The investigations specific for dysphagia are:
针对吞咽困难的特殊检查有：
- Fibre Optic direct laryngoscopy, which can view the laryngeal inlet and is useful for investigating patients of oropharyngeal dysphagia.
-光纤直接喉镜检查，它可以看到喉部入口，对口咽部吞咽困难患者的检查是有用的。
- Barium Swallow, in which patient is given a radio opaque contrast to drink and the contrast is then X rayed as it passes through the pharynx and esophagus.
-食管钡餐，病人饮用用不透明射电造影剂，当造影剂穿过咽部和食道时，用X射线照射。
- Video fluoroscopy is similar to Barium swallow.
-视频透视与钡餐检查相似。
But instead of still images, a video clip is made of the contrast's passage into the stomach.
但是，与静止图像不同的是，视频透视可以看到食物进入胃部的过程。
It is considered a better study than Barium swallow.
它被认为是比钡餐更好的方式。
- Esophageal endoscopy
食道内窥镜检查
This is particularly useful in patients with esophageal dysphagia in which a structural lesion is suspected.
-对于怀疑有结构性病变的食道吞咽困难患者特别有用。
- Esophageal Manometry
食道测压
In this test, a catheter is passed into the esophagus which measures the pressure along the length of the esophagus.
-在这项测试中，将导管插入食道，测量沿食道长度的压力。
This is useful in patients in which a motility/propulsive cause of dysphagia is suspected.
这对怀疑吞咽困难的运动性/推进性原因的患者很有用。
Management of Dysphagia
吞咽困难的管理
Obviously, the specific management of dysphagia depends on the underlying disease.
显然，吞咽困难的具体处理取决于潜在的疾病。
In general, here are the key points while managing a patient of dysphagia: Ensure adequate hydration and replenish any deficit electrolytes, such as sodium and potassium.
总的来说，在处理吞咽困难患者时，以下是要点：确保充足的水合，补充任何缺乏的电解质，如钠和钾。
Patients are usually malnourished and feeding can be started via nasogastric tube.
患者通常营养不良，可以通过鼻胃管开始喂食。
If NG tube cannot be passed, then Total Parenteral Nutrition via I/V route might be needed.
如果不能通过NG管，则可能需要通过I/V途径进行全胃肠外营养。
Patient might require feeding jejunostomy or gastrostomy for long term feeding.
病人可能需要空肠造口术或胃造口术进行长期喂养。
Food consistency variation and diet modification might help some patient with dysphagia due to a motility disorder, especially geriatric and stroke patients.
食物一致性的改变和饮食的改变可能会有助于一些由于运动障碍而导致吞咽困难的患者，特别是老年人和中风患者。
Swallow positioning and pharyngo-esophageal exercises are also useful.
吞咽姿势和咽部-食道练习也很有用。
Reduce aspiration risk by regular swallowing assessment, patient's positioning and airway protection measures.
通过定期的吞咽评估、患者体位和气道保护措施降低误吸风险。
Oral hygiene with use of mouthwashes.
使用漱口水保持口腔卫生。
Proton pump inhibitors, like Omeprazole, might reduce the severity of discomfort of dysphagia.
质子泵抑制剂，如奥美拉唑，可能会减轻吞咽困难的不适程度。
Antibiotics will reduce infection, especially in patients with increased risk of aspiration.
抗生素可以减少感染，特别是对于吸入风险增加的患者。
