《中国康复理论与实践》

《中国康复理论与实践》 ›› 2006, Vol. 12 ›› Issue (04): 282-284.

• 专题 • 上一篇    下一篇

115例急性脑卒中患者标准吞咽功能评估

孙伟平1; 阿依古丽·艾山2; 王欣华1; 黄一宁1   

  1. 1.北京大学第一医院神经内科 北京市 100034;2.新疆医科大学第二附属医院神经内科 新疆乌鲁木齐市 830028
  • 收稿日期:2006-02-14 出版日期:2006-04-25 发布日期:2006-04-25

Standardized Swallowing Assessment of Acute Stroke Patients: an Analysis of 115 Cases

SUN Wei-ping, AISHANA yi guli, WANG Xin-hua, et al   

  1. The Department of Neurology, Peking University First Hospital, Beijing 100034, China
  • Received:2006-02-14 Published:2006-04-25 Online:2006-04-25

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被引次数

253

摘要： 目的探讨急性脑卒中患者吞咽困难的发生率、危险因素及其对预后的影响。方法对115例急性脑卒中患者在入院24h内进行标准吞咽功能评估,了解有无吞咽困难;在住院期间行头部CT或MRI检查判定病变部位,以发病3个月和6个月时改良Rankin量表(mRS)评分作为卒中预后指标,分别对影响脑卒中患者吞咽功能和预后的危险因素进行多元Logistic回归分析。结果卒中后吞咽困难发生率为62.6%,不同病变部位之间无显著性差异(P=0.212);多因素Logistic回归分析显示,入院时NIH-SS评分是卒中后吞咽困难的独立危险因素(OR=5.841,95%CI1.562～21.837),吞咽困难是3个月时卒中预后不良(mRS 3～6分)的独立危险因素(OR=5.570,95% CI;1.052～29.496),但未显示其对6个月预后有显著性意义。结论吞咽困难是脑卒中急性期的常见问题,也是3个月预后的独立预测指标;入院时NIHSS评分是卒中后吞咽困难的独立危险因素。

关键词: 吞咽困难, 脑卒中, 预后, 危险因素

Abstract: ObjectiveTo investigate the incidence and risk factors of dysphagia in acute stroke patients, and its influence on prognosis.Methods115 patients with acute stroke received Standardized Swallowing Assessment (SSA) within the first 24 hours after admission to find out whether they had dysphagia. During period being in hospital, the patients received CT scans or MRI examinations to diagnose the sites of lesions in brain. The risk factors related to dysphagia and prognosis were analyzed by multivariate logistic regression with modified Rankin scale (MRS) scores at 3 months and 6 months as prognosis criterion.ResultsThe incidence of post-stroke dysphagia was 62.6%, and there was no significant difference among different brain lesion sites (P=0.212). The NIHSS score was the independent risk factor of post-stroke dysphagia (OR=5.841,95% CI:1.562～21.837), and post-stroke dysphagia was the independent risk factor of poor outcome at 3 months (OR=5.570,95% CI:1.052～29.496) in the multivariate logistic regression analysis. But dysphagia was not correlated significantly with poor outcome at 6 months in multivariate logistic regression analysis.ConclusionDysphagia is a common problem in acute stroke patients and an independent predictor for prognosis at 3 months. NIHSS score is an independent risk factor of post-stroke dysphagia.

Key words: dysphagia, stroke, prognosis, risk factor