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吞咽功能未受损的评估能否预测中风后吞咽困难患者鼻胃管的拔除?一项临床研究。

Can non-swallowing function assessment predict nasogastric tube removal in patients with poststroke dysphagia? A clinical study.

作者信息

Li Bingjie, Zhang Tong, Zhao Jun, Li Pengkun, Wu Zhangwei, Zhao Shengjie

机构信息

Department of Neurology, Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Center, Beijing, China.

出版信息

Front Neurol. 2023 Mar 1;13:984707. doi: 10.3389/fneur.2022.984707. eCollection 2022.

Abstract

OBJECTIVE

This study aimed to predict nasogastric tube (NGT) removal in patients with poststroke dysphagia (PSD) by non-swallowing function assessment.

METHODS

We enrolled 232 eligible patients and performed rehabilitation. The Fugl-Meyer assessment motor (FMM) and National Institute of Health Stroke Scale (NIHSS) scores were used to measure the motor and overall nervous system functions. Predictors for NGT removal in patients with PSD after rehabilitation were analyzed.

RESULTS

Of the 232 included patients, the NGTs were removed from 78% of them, while 22% were dependent on a feeding tube after 4 weeks of rehabilitation. Compared to the preserved NGT group, older age, a higher rate of intubation or tracheostomy, and more severe baseline functions were found in the NGT removal group. Age [odds ratio (OR) = 0.907; 95% confidence interval (CI): 0.859-0.957; = 0.000], difference in the FMM score after 4 weeks of rehabilitation (OR = 1.219; 95% CI: 1.145-1.299; = 0.00), and item 9 of NIHSS (OR = 0.488; 95% CI: 0.252-0.946; = 0.034) were predictors of NGT removal after rehabilitation.

CONCLUSION

We established a predictive model in patients with PSD using a non-swallowing assessment, which enabled us to predict swallowing recovery based on the non-swallowing function.

摘要

目的

本研究旨在通过非吞咽功能评估预测脑卒中后吞咽困难(PSD)患者鼻胃管(NGT)的拔除情况。

方法

我们纳入了232例符合条件的患者并进行康复治疗。采用Fugl-Meyer评估运动(FMM)和美国国立卫生研究院卒中量表(NIHSS)评分来测量运动和整体神经系统功能。分析康复后PSD患者拔除NGT的预测因素。

结果

在纳入的232例患者中,78%的患者拔除了NGT,而22%的患者在康复4周后仍依赖饲管。与保留NGT组相比,拔除NGT组患者年龄更大、插管或气管切开率更高、基线功能更严重。年龄[比值比(OR)=0.907;95%置信区间(CI):0.859 - 0.957;P = 0.000]、康复4周后FMM评分的差异(OR = 1.219;95%CI:1.145 - 1.299;P = 0.00)以及NIHSS的第9项(OR = 0.488;95%CI:0.252 - 0.946;P = 0.034)是康复后拔除NGT的预测因素。

结论

我们使用非吞咽评估为PSD患者建立了一个预测模型,该模型使我们能够基于非吞咽功能预测吞咽功能的恢复情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbb/10014454/36c4a4c54718/fneur-13-984707-g0001.jpg

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