脑卒中后吞咽障碍196例临床分析

目的探讨吞咽障碍与脑卒中患者预后的相关性,旨在提高对卒中后吞咽障碍的重视。方法选择住院的397例急性脑卒中患者为研究对象,入院后48h内完成标准吞咽评估(standardized swallowing assessment,SSA)。观察急性卒中后吞咽障碍发生率、误吸发生率、1个月内获得性肺炎发生率。按SSA分为吞咽障碍组和无吞咽障碍组。6个月后完成改良Rankin量表(mRS)评分、Barthel指数(BI)评分、NIHSS评分。比较2组预后情况。结果 397例卒中患者中196例吞有咽障碍(49.37%),其中误吸112例,6个月后45例仍存吞咽障碍,8例仍需胃管饮食。无吞咽障碍组BI评分、NIHSS评分分别高于、低于吞咽障碍组(P<0.05),预后良好率高于吞咽障碍组(P<0.05)。结论卒中后吞咽障碍发生率较高,吞咽障碍影响脑卒中患者预后。

Clinical analysis of 196 cases of dysphagia after stroke

Objective To analyze the clinical characteristics of dysphagia after stroke and prognosis,in order to enhance the understanding of dysphagia after stroke（DAS）.Methods Totally 397 patients were enrolled in this study.Standardized swallowing assessment（SSA） was finished within 48 hours.The incidence of dysphagia,apiration and acquired pneumonia after stroke were observed.The DAS patients were divided into dysphagia group and no dysphagia group.After 6 months,the prognosis was judged and compared by mRS,Barthel index and NIHSS.Results Of 397 stroke patients,196 patients with swallowing disorders（49.37%）,including 112 aspiration.After 6 months,45 patients still had swallowing disorder,8 patients still needed gastric diet.The prognosis in no dysphagia group was better than swallowing group（P0.05）.Conclusion The incidence of dysphagia after stroke is high,dysphagia can influence the prognosis of stroke patients.