吞咽困难对急性缺血性脑卒中患者营养状况的影响

Effect of Dysphagia on Nutritional Status of Patients with Acute Ischemic Stroke

目的探讨吞咽困难对急性缺血性脑卒中患者营养状况的临床影响。方法选择2017年5月至2018年7月本院收治的急性缺血性脑卒中患者200例,按照是否合并吞咽困难分为两组,每组100例。对所有入组者一般资料进行统计,比较两组干预后蛋白相关营养指标变化情况,统计临床症状恢复时间及1年内不良反应情况,分析吞咽功能评价量表(SSA)和主观全面评估法(SGA)变化趋势。结果吞咽困难组转铁蛋白水平、前白蛋白水平、白蛋白水平均低于无吞咽困难组(P<0.05);吞咽困难组吞咽功能恢复时间、自主进食时间、误吸控制时间晚于无吞咽困难组(P<0.05);干预后1周、1个月,吞咽困难组SSA和SGA得分低于无吞咽困难组(P<0.05);随访1年,吞咽困难组出现吸入性肺炎、营养不良、电解质紊乱、脱水比例高于无吞咽困难组(P<0.05)。结论急性缺血性脑卒中患者合并吞咽困难,则患者将出现严重的营养不良,出现自主进食能力降低,影响机体营养状况和生活能力,且后期发生并发症概率大。

Objective To explore the clinical effect of dysphagia on nutritional status of patients with acute ischemic stroke.Methods 200 cases with acute ischemic stroke admitted in our hospital from May 2017 to July 2018 were selected and divided into two groups according to whether dysphagia was complicated,with 100 cases in each group.The general data of all the enrollees were counted,the changes in protein-related nutritional indicators after the intervention of the two groups were compared,the recovery time of clinical symptoms and adverse reactions within 1 year were counted,the swallowing function assessment scale(SSA)and the subjective overall assessment method(SGA)were analyzed.Results The levels of transferrin,prealbumin and albumin in dysphagia group were lower than those in non-dysphagia group(P<0.05).The dysphagia group had a later time for the recovery time of swallowing function,self-feeding time and aspiration control time were later than those in the group without dysphagia(P<0.05).1 week after intervention and 1 month after intervention,SSA and SGA scores in the dysphagia group were lower than those in the group without dysphagia(P<0.05).Follow-up for one year showed that the incidence of aspiration pneumonia,malnutrition,electrolyte disturbance and dehydration in dysphagia group was higher than that in non-dysphagia group(P<0.05).Conclusion Acute stroke patients,if complicated with dysphagia,will suffer from severe malnutrition can reduce the ability to eat independently,affect the nutritional status and living ability of the body,and have a high probability of complications in the later stage.