Han Der-Sheng, Chang Yeun-Chung, Lu Chih-Huei, Wang Tyng-Guey
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei 100, Taiwan, ROC.
J Rehabil Med. 2005 May;37(3):189-91. doi: 10.1080/16501970410024163.
To describe the disordered swallowing patterns in recurrent cortical/subcortical stroke and first-time brainstem stroke.
A retrospective study.
Forty-seven consecutive patients, 28 with recurrent cortical/subcortical stroke and 19 with first-time brainstem stroke, referred for dysphagic evaluation to the rehabilitation department of a medical centre.
Thirty-five male and 12 female patients with a mean age of 62.0+/-11.5 years were included. The median post-stroke duration was 17.0 days. The records of clinical examination and a videofluoroscopic study of swallowing were collected through chart review. The percentages of abnormalities seen at clinical examination and videofluoroscopic swallowing study between recurrent cortical/subcortical stroke and first-time brainstem stroke patients were compared using a chi-square test.
The recurrent cortical/subcortical patients suffered from a higher rate of impaired tongue movement, drooling and aphasia at clinical examination and a higher percentage of swallowing abnormalities in oral-preparatory and oral phases in the videofluoroscopic swallowing study. The abnormal videofluoroscopic findings in first-time brainstem stroke patients predominantly occurred in the pharyngeal phase. Both groups had more difficulties swallowing thin barium than they did swallowing the thick and paste barium.
The recurrent cortical/subcortical stroke and first-time brainstem stroke patients show different manifestations in some parameters of both clinical examination and videofluoroscopic swallowing study.
描述复发性皮质/皮质下卒中及首次脑干卒中患者吞咽模式紊乱的情况。
一项回顾性研究。
连续47例患者，其中28例为复发性皮质/皮质下卒中患者，19例为首次脑干卒中患者，均被转诊至某医疗中心康复科进行吞咽功能评估。
纳入35例男性和12例女性患者，平均年龄62.0±11.5岁。卒中后中位病程为17.0天。通过查阅病历收集临床检查记录及吞咽视频透视研究资料。采用卡方检验比较复发性皮质/皮质下卒中患者与首次脑干卒中患者在临床检查及视频透视吞咽研究中出现异常的百分比。
在临床检查中，复发性皮质/皮质下卒中患者出现舌运动障碍、流涎及失语的比例更高；在视频透视吞咽研究中，其口腔准备期和口腔期吞咽异常的百分比更高。首次脑干卒中患者的视频透视异常主要出现在咽期。两组患者吞咽稀钡时比吞咽稠钡和糊状钡时更困难。
复发性皮质/皮质下卒中患者与首次脑干卒中患者在临床检查及视频透视吞咽研究的某些参数上表现不同。
