Xiao L J, Guo Q, Huang F Y, Liao M X, Zhang L L, Yan T B
Department of Rehabilitation Medicine, the Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510030, China.
Department of Speech Therapy, Shenzhen Children's Hospital, Shenzhen 518000, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 25;100(7):504-508. doi: 10.3760/cma.j.issn.0376-2491.2020.07.005.
To observe the difference of pulmonary function among patients with dysphagia after stroke, patients without dysphagia and normal people, and to explore the correlation between swallowing function and pulmonary function. From September 2018 to April 2019, 310 stroke patients were enrolled from the rehabilitation department and neurology department of sun yat-sen memorial hospital, sun yat-sen university, of which 60 were selected as standard stroke patients. Pulmonary function of the three groups was assessed by pulmonary function detector and further compared. The swallowing function of the dysphagia group after stroke was examined by using videofluroscopic swallowing study (VFSS). The swallowing function was quantitatively assessed by Rosenbek penetration-aspiration scale (PAS), dysphagia outcome and severity scale (DOSS) and videofluoroscopy dysphagia scale (VDS), and the correlation between swallowing function and respiratory function was analyzed. There were significant differences in pulmonary function among three groups (0.05). Besides the FEF25,FVC, FIVC between patients with dysphagia after stroke and patients without dysphagia, the FEF75 between patients without dysphagia and normal people (all 0.05), there were significant differences in the pairwise comparison of other indicators (all 0.05). There were correlations between PAS and MIP (-0.618, 0.001),PAS and MEP (-0.410, 0.038), PAS and PEF (-0.443, 0.024), DOSS and MIP (0.602, 0.000),DOSS and MEP (0.496, 0.005), DOSS and PEF (0.553, 0.002), VDS and MEP (-0.483, 0.012),VDS and PEF (-0.494, 0.010), respectively. The pulmonary function of dysphagia patients after stroke decrease significantly, and the severity of dysphagia is correlated with the decrease of pulmonary function.
观察脑卒中后吞咽困难患者、无吞咽困难患者及正常人的肺功能差异,探讨吞咽功能与肺功能之间的相关性。2018年9月至2019年4月,从中山大学孙逸仙纪念医院康复科和神经内科纳入310例脑卒中患者,其中60例作为标准脑卒中患者。采用肺功能检测仪评估三组患者的肺功能并进一步比较。对脑卒中后吞咽困难组患者采用电视荧光吞咽造影检查(VFSS)进行吞咽功能检查。采用Rosenbek渗透-误吸量表(PAS)、吞咽困难结果与严重程度量表(DOSS)及电视荧光吞咽困难量表(VDS)对吞咽功能进行定量评估,并分析吞咽功能与呼吸功能之间的相关性。三组间肺功能差异有统计学意义(P<0.05)。除脑卒中后吞咽困难患者与无吞咽困难患者之间的用力呼气流量25%(FEF25)、用力肺活量(FVC)、吸气肺活量(FIVC),以及无吞咽困难患者与正常人之间的用力呼气流量75%(FEF75)外(均P<0.05),其他指标两两比较差异均有统计学意义(均P<0.05)。PAS与最大吸气压(MIP)呈负相关(-0.618,P=0.001)、PAS与最大呼气压(MEP)呈负相关(-0.410,P=0.038)、PAS与呼气峰流量(PEF)呈负相关(-0.443,P=0.024),DOSS与MIP呈正相关(0.602,P=0.000)、DOSS与MEP呈正相关(0.496,P=0.005)、DOSS与PEF呈正相关(0.553,P=0.002),VDS与MEP呈负相关(-0.483,P=0.012)、VDS与PEF呈负相关(-0.494,P=0.010)。脑卒中后吞咽困难患者肺功能明显下降,吞咽困难严重程度与肺功能下降相关。