Xu Zeqin, Gu Yongquan, Li Jianxin, Wang Chunmei, Wang Rong, Huang Ying, Zhang Jian
Department of Vascular Surgery, Xuanwu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Department of Central Laboratory, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
J Back Musculoskelet Rehabil. 2019;32(1):85-91. doi: 10.3233/BMR-170801.
Stroke is the most common neurological disease that is associated with deglutition disorders. The aim of this study was to analyze dysphagia and aspiration pneumonia risk factors in post-stroke elderly inpatients.
We consecutively enrolled 212 stroke patients over sixty years of age from July 2014 to June 2015. Seventeen patients were eliminated. Stroke patients' demographics, clinical symptoms and biochemistry data were collected. Modified water swallowing test was used for the assessment of deglutition difficulty. These inpatients were classified into two groups: territorial anterior circulation infarction (n= 114) and territorial posterior circulation infarction (n= 82). Finally, dysphagia and aspiration pneumonia risk factor were analyzed between these two groups.
Number of previous cerebral infarction, National Institutes of Health Stroke Scale (NIHSS) score, masticatory muscle paralysis, abolition of gag reflex were correlated with the deglutition difficulty in these patients. In addition, NIHSS score (p= 0.017) and dysphagia (p= 0.02) were correlated with aspiration pneumonia.
In stroke inpatients over sixty years of age, it is necessary to distinguish the patients with multiple previous cerebral infarctions, high NIHSS score, masticatory muscle paralysis, and abolition of gag reflex for early detection and rehabilitation of dysphagia.
中风是与吞咽障碍相关的最常见的神经疾病。本研究的目的是分析中风后老年住院患者的吞咽困难和吸入性肺炎的危险因素。
我们连续纳入了2014年7月至2015年6月期间212名60岁以上的中风患者。排除了17名患者。收集了中风患者的人口统计学、临床症状和生化数据。采用改良饮水试验评估吞咽困难。这些住院患者被分为两组：大脑前循环梗死区域组（n = 114）和大脑后循环梗死区域组（n = 82）。最后，分析这两组之间的吞咽困难和吸入性肺炎的危险因素。
既往脑梗死次数、美国国立卫生研究院卒中量表（NIHSS）评分、咀嚼肌麻痹、咽反射消失与这些患者的吞咽困难相关。此外，NIHSS评分（p = 0.017）和吞咽困难（p = 0.02）与吸入性肺炎相关。
在60岁以上的中风住院患者中，有必要区分有多次既往脑梗死、高NIHSS评分、咀嚼肌麻痹和咽反射消失的患者，以便早期发现和康复吞咽困难。
