Min Sang Won, Oh Se Hyun, Kim Ghi Chan, Sim Young Joo, Kim Dong Kyu, Jeong Ho Joong
Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea.
Ann Rehabil Med. 2018 Dec;42(6):798-803. doi: 10.5535/arm.2018.42.6.798. Epub 2018 Dec 28.
To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke.
This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups.
The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups.
Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.
探讨缺血性脑卒中患者的峰值咳嗽流量(PCF)、肺功能测试(PFT)与吞咽困难严重程度之间的关系。
本研究纳入了2016年3月至2017年2月期间被诊断为缺血性脑卒中且接受了视频荧光吞咽造影检查(VFSS)、PCF和PFT的患者。使用视频荧光吞咽困难量表(VDS)评估吞咽困难的严重程度。对VDS、PFT和PCF进行相关性分析。根据VDS评分将患者分为三组。对VDS进行单因素方差分析,以分析不同组之间的PCF、用力肺活量(FVC)、一秒用力呼气容积(FEV1)和年龄。
VDS与PCF、VDS与FVC、VDS与FEV1的相关系数分别为-0.836、-0.508和-0.430,均在p<0.001水平上具有统计学意义。单因素方差分析表明,VDS组之间的PCF、FVC、FEV1和年龄存在统计学显著差异。在吸入性肺炎组和非吸入性肺炎组之间,观察到VDS和年龄存在统计学显著差异。
咳嗽是评估吞咽困难患者误吸风险的一个有用因素。在对缺血性脑卒中患者进行吞咽评估时,应评估其呼吸和咳嗽功能。