脑卒中吞咽障碍患者并发隐性误吸的危险因素分析

Risk factors of silent aspiration in stroke patients with swallowing disorders

目的探讨脑卒中吞咽障碍患者隐性误吸的危险因素。方法回顾性抽取2021年2年至2023年3月商丘市第一人民医院收治的脑卒中吞咽障碍患者136例,其中显性误吸3例,隐性误吸60例(误吸组),无误吸73例(未误吸组)。收集并比较两组患者临床资料,应用多因素Logistic回归分析脑卒中吞咽障碍患者隐性误吸的危险因素。结果两组患者年龄、性别、梗死部位、义齿、合并慢性支气管炎、吸烟史、自主进食、进食体位构成比比较差异有统计学意义(P<0.05),两组饮酒史构成比比较差异未见统计学意义(P>0.05)。多因素Logistic回归分析结果显示,男性、年龄≥70岁、双侧梗死、义齿、合并慢性支气管炎、吸烟史、进食体位(头/颈伸直、仰卧)是卒中后吞咽障碍患者隐性误吸的独立危险因素(OR>1,P<0.05),自主进食是保护因素(OR<1,P<0.05)。结论男性、年龄≥70岁、双侧梗死、义齿、合并慢性支气管炎、吸烟史以及采用头/颈伸直或仰卧的进食体位是卒中后吞咽障碍患者隐性误吸的独立危险因素,自主进食可能降低卒中后吞咽障碍患者的误吸风险。

Objective To investigate the risk factors of silent aspiration in stroke patients with swallowing disorders.Methods A total of 136 stroke patients with swallowing disorders admitted to the First Hospital of Shangqiu from February 2021 to March 2023 were retrospectively selected,involving 3 cases of overt aspiration,60 cases of silent aspiration(aspiration group)and 73 cases without aspiration(non-aspiration group).The clinical data of the two groups were selected and compared.The multivariate logistic regression analysis was used to analyze the influencing factors of silent aspiration.Results The difference was significant in the proportion of age,gender,infarct site,presence of dentures,chronic bronchitis,smoking history,autonomous eating,and eating posture between the two groups(P<0.05).There was no significant in the proportion of drinking history between the two groups(P>0.05).The results of multivariate logistic regression analysis showed that male,age≥70 years,bilateral infarction,presence of dentures,chronic bronchitis,smoking history,and food ingestion posture(head/neck extension,supine position)were independent risk factors for silent aspiration in patients with swallowing disorders after stroke(OR>1,P<0.05);while autonomous eating was a protective factor(OR<1,P<0.05).Conclusions Male,age≥70 years,bilateral infarction,presence of dentures,chronic bronchitis,smoking history,and food ingestion in head/neck extension or supine position are independent risk factors for silent aspiration in patients with swallowing disorders after stroke.Being able to eat independently may be reduce the risk of aspiration in patients with swallowing disorders after stroke.