急性脑卒中后吞咽障碍相关因素分析.docVIP

精品论文 参考文献 急性脑卒中后吞咽障碍相关因素分析 彭勇军 王相明 　　攀枝花市中心医院神经科 617067 　　【摘 要】目的：探讨影响急性脑卒中后吞咽障碍相关因素，为优化卒中后吞咽障碍管理提供指导。方法：选择我科住院的129例急性脑梗死患者，入院48小时内完成电视透视吞咽检查(Videofluoroscophic swallowing study,VFSS)检查，详细登记患者的临床资料：年龄、性别、是否有糖尿病史、有无高血压病史、有无脑梗死病史、是否为脑干梗死、梗死病灶大小、卒中病灶是否多发、是否有卒中后面瘫、巴塞指数(Barthel index,BI)评分、NIH卒中量表(NIH Stroke Scale,NIHSS)评分，按VFSS将129例患者分为有吞咽障碍和无吞咽障碍2组，以这11个因素为自变量，以有无吞咽障碍为应变量进性二分类logistic回归分析。结果：多因素分析显示：年龄ge;70岁、BIle;60、是否是脑干梗死，是否有卒中后面瘫最终进入回归方程，方程经检验有统计学意义（plt;0.05）。结论：年龄ge;70岁、BIle;60、是否是脑干梗死，是否有卒中后面瘫与卒中后吞咽障碍独立相关。积极改善卒中后面瘫及生活自理能力可望改善卒中后吞咽障碍患者的吞咽功能。 　　【关键词】脑梗死；吞咽障碍；因素 　　【中图分类号】R743.3 【文献标识码】B 【文章编号】1674-8999（2015）9-0697-02 　　Analysis of the related factors dysphagia following actue stroke. 　　 WANG Xiang ming, ZHANG Yue hui, Zhan cheng Lin Wen 　　（Department of Nenrology, Central Hospital of Pan Zhi hua,Panzhihua of sic( 617023, china） 　　【Abstract】Objective：To investigate the related factors influencing dysphagia after actue stroke in order to provide effective methods for management of dysphagia after actue stroke(DAS). Methods：129 cerebral infarction patients were enrolled in this study. Their wallowing function were evulated within admission 48 hours by VFSS.129 patients were divided into dysphagia group and no dysphagia group by VFSS.The correlations between the dysphagia and the related factors such as the age, sex, the previous positive/negative diabetes, strok history, history hypertension, whether the brain-stem strok, strok size, single or multiple strok lesion, whether facial paralysis,NIH Stroke Scale(NIHSS)Score and Barthel index(BI) were analyzed by multiple stepwise regression analysis. Results：The agege;70,BIle;60,whether the brain-stem strok and whether facial paralysis wre correlated with DAS. conclusion：The agege;70,BIle;60,whether the brain-stem strok and whether facial paralysis wre independently correlated with DAS. The stroke patients accompanied by lower BI, older, brainstem stroke patients and facial paralysis should be evaluated for swallo