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吞咽困难对急性脑卒中患者短期预后的影响。

Influence of dysphagia on short-term outcome in patients with acute stroke.

机构信息

Department of Rehabilitation Medicine, Saitama Medical University International Medical Center, Hidaka, Japan.

出版信息

Am J Phys Med Rehabil. 2011 Apr;90(4):316-20. doi: 10.1097/PHM.0b013e31820b13b2.

Abstract

OBJECTIVE

The aim of this study was to determine whether dysphagia present at initial swallowing evaluation is associated with the type of diet eaten at the time of discharge and the location to which the patient is transferred after discharge.

DESIGN

A total of 409 newly diagnosed acute stroke patients were studied.

RESULTS

After hospital discharge, 140 patients returned home, 250 were transferred to another hospital for rehabilitation, and 7 were admitted to a nursing home. Twelve patients died. A total of 205 patients were on a regular diet, 96 were receiving a dysphagia diet, and 96 were on enteral feeding at discharge. A total of 90.7% (127/140) of patients who were discharged home were on a regular diet. Most of the patients on a dysphagia diet or enteral feeding could not return home. The scores of the functional independence measure were higher in the patients who returned to their homes than in other groups.

CONCLUSIONS

Although it is necessary to indicate other factors, such as the physical status to establish better rehabilitation networks, clinical assessment of swallowing in acute stroke is very important to determine whether the patients can go home directly.

摘要

目的

本研究旨在确定初始吞咽评估时存在吞咽困难是否与出院时所吃的饮食类型以及出院后患者转移的地点有关。

设计

共研究了 409 名新诊断的急性脑卒中患者。

结果

出院后,140 名患者返回家中,250 名患者转往其他医院进行康复治疗,7 名患者入住疗养院。12 名患者死亡。共有 205 名患者采用常规饮食,96 名患者采用吞咽困难饮食,96 名患者出院时采用肠内喂养。90.7%(127/140)的出院回家患者采用常规饮食。大多数采用吞咽困难饮食或肠内喂养的患者无法返回家中。返回家庭的患者的功能独立性量表评分较高。

结论

尽管有必要指出其他因素,如建立更好的康复网络的身体状况,但对急性脑卒中患者的吞咽临床评估对于确定患者是否可以直接回家非常重要。

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