卒中后吞咽困难患者基于吞咽功能的吸入性肺炎临床预测模型的初步研究

The Preliminary Study of Clinical Predictive Model of Swallowing Function of Aspiration Pneumonia Based on Swallowing Function in Dysphagia Ischemic Stroke Patients

目的对卒中后吞咽困难患者吸入性肺炎的基于吞咽功能的临床预测模型的建立进行初步探讨。方法对105例缺血性卒中后吞咽困难的患者进行临床吞咽功能评估和电视透视检查,记录吞咽困难的症状和体征,并记录住院期间吸入性肺炎是否发生。采用x^2检验判断所记录的症状和体征是否与住院期间吸入性肺炎相关,Logistic回归分析判断临床相关因素的预测价值。结果与住院期间吸入性肺炎相关的临床因素包括进食相关的呛咳,舌无力,口内食物残留,无效吞咽,进食或饮水后嗓音改变,其中无效吞咽能够预测住院期间的吸入性肺炎,OR值7.700,预测准确度83.8%。结论临床吞咽评估发现无效吞咽是住院期间吸入性肺炎的独立危险因素。

Objective To establish the clinical predictive model of aspiration pneumonia based on swallowing function in ischemic stroke inpatients. Methods Total 105 stroke patients had the clinical assessment of swallowing and videofluoroscopy swallowing study. Patients who had aspiration pneumonia were recorded. χ2 analysis and logistic regression analysis were used to select the associated predictors of aspiration pneumonia. Results Coughing after swallowing food, weakness of the tongue, residue food in the mouth after swallow, invalid swallow and voice change after swallow were associated with aspiration pneumonia during admission. Invalid swallow could predict aspiration pneumonia, the OR was 7.700 and the predictive accuracy was 83.8%. Conclusion Invalid swallow detected by clinical assessment of swallowing was the independent predictor of aspiration pneumonia.