225例急性脑卒中吞咽功能评估

Evaluation of Swallowing Function in 225 Cases of Patients with Acute Cerebral Stroke

目的：探讨了卒中后吞咽困难的发生率、与卒中部位、并发肺部感染的关系及对预后的影响。方法：分析了我院2011年3月～2012年2月收治的225例急性脑卒中患者的临床资料，并在患者入院24内对其进行吞咽功能评估，对患者行头部CT或MRI检查判定病变部位，根据吞咽障碍程度分为轻、中、重3组进行比较。结果：225例急性脑卒中患者中，其中出现吞咽困难患者108例，发生率为48%；单侧大脑半球30例，占44.3%；多发及双侧大脑半球42例，占53.2%；脑干及小脑35例，占53%。不同病变部位的脑卒中患者的吞咽困难发生率比较，差异无显著性（P＞0.05）；脑干及小脑卒中患者发生重度吞咽障碍明显多于其他部位，差异有统计学意义（P＜0.05）；轻度吞咽障碍患者中并发肺部感染患者4例，占6.67%，中轻度吞咽障碍并发肺部感染患者9例，占36%，在重度吞咽障碍患者中并发肺部感染患者21例，占91.30%，重度吞咽障碍患者并发肺部感染的患者显著对于中轻度患者，差异有显著性（P＜0.05）。结论：吞咽困难是脑卒中急性期的常见问题，吞咽功能障碍对脑卒中患者的预后产生一定的影响。

Objective： To investigate the occurrence of dysphagia after stroke rate and stroke positions,the relationship between pulmonary infection and its impact on prognosis.Methods：Analyzed the clinical data of 225 cases of acute stroke patients in our hospital from March 2011 to February 2012,in 24 patients admitted to hospital within its assessment of swallowing function of patients with head CT or MRI determination lesion,according to the degree of swallowing disorders are divided into mild,moderate and severe groups were compared.Results：225 cases of acute stroke patients,of which 108 cases occurred in patients with dysphagia,the rate was 48%;unilateral cerebral hemisphere in 30 cases,44.3%;multiple and bilateral cerebral hemispheres in 42 cases,53.2%;brainstem and the cerebellum in 35 cases,accounting for 53%.The incidence of stroke in patients with dysphagia different lesions,the difference was not signiifcant （P〉0.05）;brain stem and small stroke patients with severe dysphagia occurred signiifcantly more than other parts of the difference was statistically signiifcant （P〈0.05）;mild dysphagia in patients with pulmonary infection in 4 patients （6.67%）, mild dysphagia in patients with pulmonary infection in 9 cases （36%）,dysphagia in patients with severe pulmonary infection in 21 patients,accounting for 91.30%of patients with severe dysphagia patients with pulmonary infection in patients with mild to signiifcant,the difference was signiifcant （P〈0.05）.Conclusion：Dysphagia is a common problem acute stroke,swallowing dysfunction have a certain impact on the prognosis of stroke patients.