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1、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(Videofluoroscophicswallowingstudy,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(Barthelindex,BI}评分、N
2、IH卒中量表(NIHStrokeScale,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≥70岁、BI≤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(p<0.05)。结论：年龄≥70岁、BI≤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。
3、【关键词】脑梗死；吞咽障碍；因素【中图分类号1R743.3【文献标识码】B【文章编号】1674-8999(2015)9-0697-02Analysisoftherelatedfactorsdysphagiafollowingactuestroke.WANGXiangming,ZHANGYuehui,ZhanchengLinWen(DepartmentofNenrology,CentralHospitalofPanZhihua,Panzhihuaofsic(617023,china)【Abstract】Objective：T
4、oinvestigatetherelatedfactorsinfluencingdysphagiaafteractuestrokeinordertoprovideeffectivemethodsformanagementofdysphagiaafteractuestroke(DAS).Methods：129cerebralinfarctionpatientswereenrolledinthisstudy.Theirwallowingfunctionwereevulatedwithinadmission48hoursbyVF
5、SS.129patientsweredividedintodysphagiagroupandnodysphagiagroupbyVFSS.Thecorrelationsbetweenthedysphagiaandtherelatedfactorssuchastheage,sex,thepreviouspositive/negativediabetes,strokhistory,historyhypertension,whetherthebrain-stemstrok,stroksize,singleormultiplest
6、roklesion,whetherfacialparalysis,IHHStrokeScale(NIHSS)ScoreandBarthelindex(BI)wereanalyzedbymultiplestepwiseregressionanalysis.Results：Theage≥70,BI≤60,whetherthebrain-stemstrokandwhetherfacialparalysiswrecorrelatedwithDAS.conclusion：Theage≥70,BI≤60,wh
7、etherthebrain-stemstrokandwhetherfacialparalysiswreindependentlycorrelatedwithDAS.ThestrokepatientsaccompaniedbylowerBI,older,brainstemstrokepatientsandfacialparalysisshouldbeevaluatedforswallowingfunctionindetail.Activelyimprovefacialparalysisafterstrokeandlifese
8、lf-careabilitywereexpectedtoimprovethepatients'swallowingfunction.【KeyWords]dysphagia,stroke,elatedfactor卒中后吞咽障碍发生率高，是急性脑脑卒中患者预后不良的独立危险因素[1】。吞咽的生理、解剖结构复
