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构音障碍作为中风后吞咽困难的预测指标。

Dysarthria as a predictor of dysphagia following stroke.

作者信息

Bahia Mariana Mendes, Mourão Lucia Figueiredo, Chun Regina Yu Shon

出版信息

NeuroRehabilitation. 2016;38(2):155-62. doi: 10.3233/NRE-161305.

Abstract

BACKGROUND

Stroke is the leading cause of mortality and disability worldwide. Important sequels are frequent, including dysphagia and communication disorders.

OBJECTIVE

to determine the prevalence of dysphagia and communication disorders following stroke, and to identify if communication disorders can predict dysphagia.

METHODS

Thirty-one prospective and consecutive patients were admitted to the Otolaryngology-Dysphagia Outpatient Clinic with diagnosis of ischemic or hemorrhagic stroke. Stroke was confirmed by computed tomography or magnetic resonance imaging, and medical evaluation. All patients had a swallowing and communication evaluation. We compared patients with and without dysphagia, and established the co-occurrence among dysphagia and communication disorders.

RESULTS

Twenty-five patients presented dysphagia. Aphasia occurred in 32.3% of the patients; dysarthria in 45.2%. Dysphagia and aphasia co-occurred in 29% of the population; dysphagia and dysarthria in 45.2%; the three conditions co-occurred in 22.6%. Dysarthria was a predictor of dysphagia, and it was associated with the presence of oral stage problems.

CONCLUSIONS

A comprehensive evaluation of dysphagia, aphasia, and dysarthria are important to improve clinical outcome following stroke. The identification of dysarthria as a predictor of dysphagia can help identify risk for dysphagia in stroke and assist in the therapeutic process of swallowing problems.

摘要

背景

中风是全球范围内导致死亡和残疾的主要原因。重要的后遗症很常见,包括吞咽困难和沟通障碍。

目的

确定中风后吞咽困难和沟通障碍的患病率,并确定沟通障碍是否可预测吞咽困难。

方法

31例连续的前瞻性患者因缺血性或出血性中风诊断入住耳鼻喉科吞咽门诊。通过计算机断层扫描或磁共振成像及医学评估确诊中风。所有患者均进行了吞咽和沟通评估。我们比较了有吞咽困难和无吞咽困难的患者,并确定了吞咽困难和沟通障碍之间的共存情况。

结果

25例患者出现吞咽困难。32.3%的患者出现失语;45.2%的患者出现构音障碍。29%的患者同时出现吞咽困难和失语;45.2%的患者同时出现吞咽困难和构音障碍;22.6%的患者三种情况同时出现。构音障碍是吞咽困难的一个预测指标,且与口腔期问题的存在有关。

结论

对吞咽困难、失语和构音障碍进行全面评估对于改善中风后的临床结局很重要。将构音障碍确定为吞咽困难的预测指标有助于识别中风患者吞咽困难的风险,并有助于吞咽问题的治疗过程。

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