Kidd D, Lawson J, Nesbitt R, MacMahon J
Department of Respiratory Medicine, Belfast City Hospital, UK.
QJM. 1995 Jun;88(6):409-13.
Sixty consecutive patients admitted to a teaching hospital with acute stroke were studied prospectively for 3 months to define the natural history and consequences of lung aspiration. Using videofluoroscopy, aspiration was identified in 25 patients (42%) within 72 h of stroke onset, and had resolved in all but three patients (8%) after 3 months. It was closely related to the presence of dysphagia, which itself resolved within 2 weeks in all but the persistent aspirators. Lower respiratory tract infection (LRTI) was more common in aspirating patients (68%) than non-aspirators (6%). The use of intravenous fluids without oral intake did not appear to prevent LRTI in aspirating patients who were also dysphagic. Pneumonia occurred after 2 weeks in the three patients subsequently found to aspirate persistently. Aspiration is a transient phenomenon in most cases of acute stroke; it is associated with a high incidence of LRTI, but mortality in this series was not significantly associated either with respiratory tract infection or aspiration itself.
对一家教学医院连续收治的60例急性中风患者进行了为期3个月的前瞻性研究，以明确肺部误吸的自然病程及后果。通过视频荧光透视检查，在中风发作后72小时内，25例患者（42%）被发现有误吸，3个月后除3例患者（8%）外，其余患者的误吸均已缓解。误吸与吞咽困难密切相关，除持续有误吸的患者外，吞咽困难在2周内均自行缓解。下呼吸道感染（LRTI）在有误吸的患者中（68%）比无误吸的患者中（6%）更为常见。对于同时存在吞咽困难的有误吸患者，不摄入口服食物仅使用静脉输液似乎无法预防LRTI。随后发现持续有误吸的3例患者在2周后发生了肺炎。在大多数急性中风病例中，误吸是一种短暂现象；它与LRTI的高发生率相关，但在本系列研究中，死亡率与呼吸道感染或误吸本身均无显著关联。
