成人心脏外科术后患者发生获得性吞咽障碍的相关因素-中国循环杂志.PDFVIP

中国循环杂志 2016 年 8 月 第 31 卷 第 8 期（总第 218 期）Chinese Circulation Journal，August，2016，Vol. 31 No.8（Serial No.218） 793 临床研究 成人心脏外科术后患者发生获得性吞咽障碍的相关因素研究 * 胡可鉴，周萌 ，梁涛，王琪，刘加林，余萌，魏艳艳，石丽 摘要 目的：探讨成人心脏外科术后患者发生获得性吞咽障碍的相关因素。 方法：将 2015-03 至 2015-09 在我院经患者及家属知情同意后采用洼田饮水试验对成人心脏外科术后患者进行吞 咽功能筛查，32 例吞咽障碍的患者为病例组，从同时期同病区心脏术后无获得性吞咽障碍的 420 例患者为对照组，使 用非条件 Logistic 回归方程分析发生获得性吞咽障碍的相关因素。 结果：本研究中心脏外科术后发生获得性吞咽障碍的患者 32 例，总体发生率为 7.08%。经多因素 Logistic 回归分析， 气管插管时间 [P 0.001，比值比（OR）=1.060]、术前合并心律失常（P=0.019，OR=2.780）、纽约心脏协会（NYHA）心功 能分级（P=0.033，OR=1.789）、欧洲心血管手术危险因素评分（Euroscore 评分，P=0.040，OR=1.216）为心脏外科术后患 者发生获得性吞咽障碍的相关因素。 结论：心脏手术患者的气管插管时间、术前合并心律失常、NYHA 心功能分级、Euroscore 评分等都可能会影响心 脏外科术后患者获得性吞咽障碍的发生，对于有些特征的高危患者，在术后饮水时医务人员应特别注意采取相应的措施， 尽量减少获得性吞咽障碍相应并发症的发生。 关键词 心脏外科手术；吞咽障碍；病例对照研究；相关因素 Relevant Factor Analysis for Acquired Swallowing Disorders in Adult Patients After Cardiac Surgery HU Ke-jian, ZHOU Meng, LIANG Tao, WANG Qi, LIU Jia-lin, YU Meng, WEI Yan-yan, SHI Li. Second Division of Adult Recovery, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037), China Corresponding Author: SHI Li, Email: stone610108@126.com Abstract Objective: To explore the relevant factors of acquired swallowing disorders in adult patients after cardiac surgery. Methods: A Jiatian water swallowing screening test was conducted for adult patients after cardiac surgery in our hospital from 2015-03 to 2015-09. There were 32 patients with acquired swallowing disorder defined as Case group and meanwhile 420 patients without swallowing disorder at the same word defined as Control group. Non-conditional Logistic regression analysis was applied to study the relevant factors for acquired swallowing disorders. Results: The overall incidence of acquired sw