脑卒中后吞咽障碍的影响因素分析及康复治疗效果研究

Analysis of influencing factors and study on rehabilitation treatment effect of dysphagia after stroke

目的分析脑卒中后吞咽障碍的影响因素及康复治疗效果,以为临床治疗该病及改善患者预后提供参考。方法选取2021年9月至2022年9月于我院神经内二科住院的111例脑卒中患者为研究对象,根据是否合并吞咽障碍将其分为吞咽障碍组和吞咽正常组。采用洼田饮水试验和容积-黏度吞咽测试(V-VST)完成患者吞咽功能评估;收集患者年龄、性别、美国国立卫生研究院脑卒中量表(NIHSS)评分、病程、后遗症个数等资料。通过单因素及二元Logistic回归分析探讨影响脑卒中患者发生吞咽障碍的因素;并分析脑卒中后吞咽障碍患者的康复治疗效果。结果吞咽障碍86例,吞咽正常25例。单因素分析结果显示,吞咽障碍组和吞咽正常组的年龄、NIHSS评分及后遗症个数比较,差异具有统计学意义(P<0.05)。二元Logistic回归分析结果显示,年龄和后遗症个数是脑卒中患者发生吞咽障碍的独立危险因素(P<0.05)。脑卒中后吞咽障碍患者出院时的洼田饮水试验评分及治疗参数均优于入院时,差异有统计学意义(P<0.05)。结论脑卒中患者的吞咽障碍发生率较高,其与年龄、后遗症个数有关,及时给予此类患者康复治疗,可以改善预后。

Objective To analyze the influencing factors and the rehabilitation treatment effect of dysphagia after stroke,so as to provide reference for clinical treatment of diseases and improve the prognosis of patients.Methods A total of 111 stroke patients hospitalized in the No.2 neurology department of our hospital from September 2021 to September 2022 were selected as the research objects and divided into dysphagia group and normal swallowing group according to whether they had dysphagia.The swallowing function of the patients was evaluated by the Kubota drinking water test and Volume-Viscosity Swallow Test(V-VST);the patients'age,gender,National Institute of Health Stroke Scale(NIHSS)score,course of disease,number of sequelae and other data were collected.Univariate and binary Logistic regression analysis were used to explore the factors affecting dysphagia in stroke patients;the rehabilitation treatment effect of patients with dysphagia after stroke was analyzed.Results There were 86 cases of dysphagia and 25 cases of normal swallowing.Univariate analysis results showed that there were statistically significant differences in age,NIHSS score and number of sequelae between the dysphagia group and the normal swallowing group(P<0.05).The binary Logistic regression analysis results showed that age and the number of sequelae were independent risk factors for dysphagia in stroke patients(P<0.05).The Kubota drinking water test score and treatment parameters of patients with dysphagia after stroke at discharge were better than those at admission,and the differences were statistically significant(P<0.05).Conclusion The incidence of dysphagia in stroke patients is high,which is related to age and the number of sequelae,timely rehabilitation treatment of such patients can improve the prognosis.