影响脑卒中后吞咽障碍康复预后的多因素分析

Multiple Factors Analysis on the Prognosis of Dysphagia After Stroke

目的探讨影响脑卒中后吞咽障碍康复预后的相关因素。方法选择符合入组条件的170例脑卒中并吞咽障碍患者,根据其出院时的吞咽功能改善情况分为预后良好组和预后不良组;对可能影响脑卒中后吞咽障碍康复预后的10项因素,做单因素分析和多因素Logistic回归分析。结果单因素分析显示,年龄(>70岁)、认知障碍、脑干受损、双侧大脑半球受损、低白蛋白血症(<35 g/L)、Barthel分值低(<60分)6个因素为影响吞咽障碍康复疗效的危险因素;多因素Logistic回归分析表明,年龄(>70岁)、认知障碍、脑干受损、双侧大脑半球受损是影响吞咽康复的独立危险因素。结论年龄(>70岁)、认知障碍、脑干受损、双侧大脑半球受损是影响脑卒中后吞咽障碍康复的重要因素,可协助判断预后。

Objective To explore the related factors affecting the prognosis of dysphagia after stroke. Methods 170 patients with stroke and dysphagia who met the enrollment criteria were selected according to their swallowing function improvement at the time of discharge. The patients were divided into two groups with good prognosis and poor prognosis. 10 factors that could influence the prognosis of dysphagia after stroke were done univariate analysis and multivariate logistic regression analysis. Results Univariate analysis showed age（〉70 years）, cognitive impairment, brain stem damage, bilateral cerebral hemisphere damage, hypoalbuminemia（〈35 g/L）, and low Barthel score（〈60 points） Six factors were risk factors for dysphagia in patients with rehabilitation; Multivariate logistic regression showed that age（〉70 years old）, cognitive impairment, brainstem damage, and bilateral cerebral hemisphere damage were independent risk factors for swallowing rehabilitation. Conclusion Age（〉 70 years）, cognitive impairment, brain stem damage and bilateral hemispheric damage are important factors influencing rehabilitation of dysphagia after stroke, which can help to predict prognosis.