文章摘要
尤素伟,冯俊艳,冯 欣,周 慧,崔学静,张 璇,王 静,郭 鹏,覃国勇.急性脑梗死患者伴吞咽障碍的临床特征及发生卒中相关性肺炎的影响因素分析[J].,2022,(6):1186-1190
急性脑梗死患者伴吞咽障碍的临床特征及发生卒中相关性肺炎的影响因素分析
Clinical Characteristics of Patients with Acute Cerebral Infarction with Dysphagia and Analysis of Influencing Factors of Stroke Associated Pneumonia
投稿时间:2021-08-25  修订日期:2021-09-21
DOI:10.13241/j.cnki.pmb.2022.06.039
中文关键词: 急性脑梗死  吞咽功能障碍  卒中相关性肺炎  临床特征  影响因素
英文关键词: Acute cerebral infarction  Dysphagia  Stroke associated pneumonia  Clinical features  Influence factor
基金项目:河北省医学科学研究重点计划项目(201701609);国家自然科学基金项目(81151530)
作者单位E-mail
尤素伟 河北省邯郸市中心医院神经内一科 河北 邯郸 056001 yousuwei2011@126.com 
冯俊艳 河北医科大学第二医院神经内科 河北 石家庄 050000  
冯 欣 河北省邯郸市中心医院神经内一科 河北 邯郸 056001  
周 慧 河北省邯郸市中心医院神经内一科 河北 邯郸 056001  
崔学静 河北省邯郸市中心医院神经内一科 河北 邯郸 056001  
张 璇 河北省邯郸市中心医院神经内一科 河北 邯郸 056001  
王 静 河北省邯郸市中心医院神经内一科 河北 邯郸 056001  
郭 鹏 河北省邯郸市中心医院神经内一科 河北 邯郸 056001  
覃国勇 重庆市大足区人民医院神经内科 重庆 402360  
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中文摘要:
      摘要 目的:分析急性脑梗死患者伴吞咽障碍的临床特征及发生卒中相关性肺炎(SAP)的影响因素。方法:选取 2019年 10月~2021年 10月本院收治的 190例急性脑梗死患者为调查研究对象,根据患者的洼田饮水试验评分分为吞咽良好组(98例)和吞咽障碍组(92例),对比两组患者的临床资料,探讨急性脑梗死患者伴吞咽障碍的临床特征。并对 92例吞咽障碍组患者发病期间SAP发生率进行统计,并将患者分为 SAP组和非 SAP组,对两组患者的基础资料、临床资料等进行组间对比分析,并采用单因素分析和多因素 Logistic回归分析探讨影响急性脑梗死吞咽障碍患者发生 SAP的危险因素。结果:吞咽障碍组与吞咽良好组患者的性别、体质指数(BMI)、吸烟史、饮酒史、基础疾病史等比较无统计学差异(P>0.05),而吞咽障碍组患者的年龄、美国国立卫生院神经功能缺损评分(NIHSS)、梗死面积、梗死部位脑干比例均高于吞咽功能良好组(P<0.05)。92例急性脑梗死伴吞咽障碍患者中有 34例患者发生 SAP,发生率为 36.96%。经单因素分析显示,SAP组与非 SAP组患者的性别、BMI、饮酒史、高血压病史、高脂血病史比较无统计学差异(P>0.05),而 SAP组患者的年龄、NIHSS评分、吸烟史患者比例、糖尿病史患者比例均高于非 SAP组(P<0.05)。经 Logistic多因素回归分析显示,高龄、高 NIHSS评分、吸烟史、糖尿病史是急性脑梗死伴吞咽障碍并发 SAP发生的独立危险因素(P<0.05,OR>1)。结论:急性脑梗死患者中高龄、神经功能缺损严重、梗死面积大以及脑干部位梗死患者易出现吞咽功能障碍,且有部分患者会出现 SAP,而高龄、高 NIHSS评分、吸烟史、糖尿病史是诱发 SAP发生的影响因素,值得临床关注。
英文摘要:
      ABSTRACT Objective: To analyze the clinical characteristics of acute cerebral infarction with dysphagia and the influencing factors of stroke associated pneumonia (SAP). Methods: 190 patients with acute cerebral infarction who were treated in our hospital from October 2019 to October 2021 were selected as the research objects. According to the score of Watian drinking water test, they were divided into good swallowing group (98 cases) and dysphagia group (92 cases). The clinical data of the two groups were compared, the clinical characteristics of patients with acute cerebral infarction with dysphagia were explored. The incidence of SAP in 92 patients with dysphagia group onset period was counted, and the patients were divided into SAP group and non SAP group. The basic data and clinical data of the two groups were compared and analyzed, and the risk factors of SAP in patients with acute cerebral infarction with dysphagia were discussed by univariate analysis and multivariate Logistic regression analysis. Results: There were no significant differences in gender, body mass index(BMI), smoking history, drinking history and basic disease history between dysphagia group and good swallowing group(P>0.05), but the age, National Institutes of health neurological deficit score (NIHSS), infarct size, brain stem ratio of infarct site in dysphagia group were higher than those in good swallowing group(P<0.05). SAP occurred in 34 of 92 patients with acute cerebral infarction with dysphagia, with an incidence of 36.96%. Univariate analysis showed that there were no significant differences in the gender, BMI, drinking history, history of hypertension and history of hyperlipidemia between SAP group and non-SAP group (P>0.05), while the age, NIHSS score, smoking history ratio and diabetes history proportion in SAP group were higher than those in non-SAP group (P<0.05). Logistic regression analysis showed that advanced age, high NIHSS score, smoking history and diabetes history were independent risk factors for acute cerebral infarction with dysphagia complicated with SAP (P<0.05, OR > 1). Conclusion: In elderly patients with acute cerebral infarction, severe neurological deficits, large infarct size and brainstem infarction patients are prone to swallowing dysfunction, and some patients will develop SAP. Older age, high NIHSS score, smoking history and diabetes history are the influencing factors of SAP induction, which deserve clinical attention.
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