Little is known about dysphagia after pontine infarction. In this study, we evaluated the incidence of dysphagia after isolated pontine infarction and identified the predictive factors for the occurrence of dysphagia....Little is known about dysphagia after pontine infarction. In this study, we evaluated the incidence of dysphagia after isolated pontine infarction and identified the predictive factors for the occurrence of dysphagia. A total of 146 patients were included in this study. All patients underwent clinical testing for dysphagia within 1 day after admission and at the time of discharge. We compared the incidence of dysphagia between patients with unilateral pontine infarction and those with bilateral pontine infarction. To evaluate the functional status of patients, we investigated their initial modified Rankin Scale（mRS） score and initial National Institutes of Health Stroke Scale（NIHSS） score within 1 day of admission. Of 146 patients, 50（34.2%） had dysphagia initially within 1 day after admission. At the second evaluation at the time of discharge, dysphagia was diagnosed in 24 patients（16.4%）. Patients with bilateral pontine infarction were more likely to present with dysphagia. In addition, clinical severity（in terms of mRS and NIHSS scores） was identified as a predictor of dysphagia in patients with cerebral infarction（multiple binary logistic regression analysis, mRS： P = 0.011, NIHSS： P = 0.004）. Dysphagia frequently occurs in patients with isolated pontine infarction. Clinicians should pay particular attention to the occurrence of dysphagia, especially in patients with bilateral pontine infarction or high functional disability.展开更多
目的探讨洼田吞咽功能评分联合荧光吞咽透视检查评分在神经性吞咽障碍患者营养不良中的预测价值。方法回顾性分析2018年5月至2021年5月浙江中医药大学附属温州中医院收治的92例神经性吞咽障碍患者的临床资料,根据患者是否发生营养不良...目的探讨洼田吞咽功能评分联合荧光吞咽透视检查评分在神经性吞咽障碍患者营养不良中的预测价值。方法回顾性分析2018年5月至2021年5月浙江中医药大学附属温州中医院收治的92例神经性吞咽障碍患者的临床资料,根据患者是否发生营养不良将其分为发生组(n=24)和未发生组(n=68)。比较两组患者的洼田吞咽功能评分、荧光吞咽透视检查评分和临床特征,采用Logistic回归分析探讨影响神经性吞咽障碍患者发生营养不良的因素,绘制受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析洼田吞咽功能评分和荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的价值。结果随访1个月,共有24例患者发生营养不良,营养不良发生率26.09%。发生组患者的洼田吞咽功能评分高于未发生组,荧光吞咽透视检查评分低于未发生组(P<0.05)。发生组患者的体质量指数<18.5kg/m^(2)、饮食≤正常1/2、意识障碍患者的构成比及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分均显著高于未发生组(P<0.05)。多因素Logistic回归分析结果显示,饮食状况、意识障碍、NIHSS评分、洼田吞咽功能评分和荧光吞咽透视检查评分均是影响神经性吞咽障碍患者发生营养不良的独立危险因素(P<0.05)。ROC曲线显示,洼田吞咽功能评分、荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的最佳截断值分别为2.73分、4.12分,敏感度分别为87.50%、79.17%,特异性分别为76.47%、85.29%,曲线下面积(area under the curve,AUC)分别为0.800,0.835,二者联合预测的AUC为0.851,敏感度和特异性分别为79.17%和97.06%。结论神经性吞咽障碍营养不良患者的洼田吞咽功能评分和荧光吞咽透视检查评分均发生异常变化,二者可作为预测神经性吞咽障碍患者发生营养不良的敏感指标。展开更多
目的:观察调神利咽针刺联合咽部冷刺激对急性脑梗死后吞咽障碍患者吞咽功能、营养状况及神经功能的影响,为临床治疗提供借鉴。方法:收集2018年1月至2019年1月收治的急性脑梗死后发生吞咽障碍的患者86例,通过随机数字表法将其分为治疗组...目的:观察调神利咽针刺联合咽部冷刺激对急性脑梗死后吞咽障碍患者吞咽功能、营养状况及神经功能的影响,为临床治疗提供借鉴。方法:收集2018年1月至2019年1月收治的急性脑梗死后发生吞咽障碍的患者86例,通过随机数字表法将其分为治疗组和对照组各43例,两组均予常规西医治疗,病情稳定无进展后于入院第3天行咽部冷刺激治疗,在此基础上治疗组联合调神利咽针刺治疗,疗程均为3周。治疗前后,分别测定两组患者吞咽功能、微型营养评价(mini nutritional assessment,MNA)评分及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分,并据以判定吞咽障碍疗效、营养状况及神经功能变化。结果:治疗3周后,治疗组和对照组吞咽功能改善总有效率分别为90.70%、76.74%,差异有统计学意义(P<0.05);治疗3周后,两组MNA评分均较治疗前升高(P<0.05),且治疗组高于对照组(P<0.05),两组营养状况良好率均较治疗前升高、营养不良危险率均较治疗前降低(P<0.05),且治疗组效果优于对照组(P<0.05);治疗3周后,两组NIHSS评分均较治疗前明显降低(P<0.05),且治疗组低于对照组(P<0.05)。结论:调神利咽针刺联合咽部冷刺激可以有效改善急性脑梗死后吞咽障碍患者吞咽功能、营养状况,同时提升其神经功能,值得临床借鉴。展开更多
文摘Little is known about dysphagia after pontine infarction. In this study, we evaluated the incidence of dysphagia after isolated pontine infarction and identified the predictive factors for the occurrence of dysphagia. A total of 146 patients were included in this study. All patients underwent clinical testing for dysphagia within 1 day after admission and at the time of discharge. We compared the incidence of dysphagia between patients with unilateral pontine infarction and those with bilateral pontine infarction. To evaluate the functional status of patients, we investigated their initial modified Rankin Scale（mRS） score and initial National Institutes of Health Stroke Scale（NIHSS） score within 1 day of admission. Of 146 patients, 50（34.2%） had dysphagia initially within 1 day after admission. At the second evaluation at the time of discharge, dysphagia was diagnosed in 24 patients（16.4%）. Patients with bilateral pontine infarction were more likely to present with dysphagia. In addition, clinical severity（in terms of mRS and NIHSS scores） was identified as a predictor of dysphagia in patients with cerebral infarction（multiple binary logistic regression analysis, mRS： P = 0.011, NIHSS： P = 0.004）. Dysphagia frequently occurs in patients with isolated pontine infarction. Clinicians should pay particular attention to the occurrence of dysphagia, especially in patients with bilateral pontine infarction or high functional disability.
文摘目的探讨洼田吞咽功能评分联合荧光吞咽透视检查评分在神经性吞咽障碍患者营养不良中的预测价值。方法回顾性分析2018年5月至2021年5月浙江中医药大学附属温州中医院收治的92例神经性吞咽障碍患者的临床资料,根据患者是否发生营养不良将其分为发生组(n=24)和未发生组(n=68)。比较两组患者的洼田吞咽功能评分、荧光吞咽透视检查评分和临床特征,采用Logistic回归分析探讨影响神经性吞咽障碍患者发生营养不良的因素,绘制受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析洼田吞咽功能评分和荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的价值。结果随访1个月,共有24例患者发生营养不良,营养不良发生率26.09%。发生组患者的洼田吞咽功能评分高于未发生组,荧光吞咽透视检查评分低于未发生组(P<0.05)。发生组患者的体质量指数<18.5kg/m^(2)、饮食≤正常1/2、意识障碍患者的构成比及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分均显著高于未发生组(P<0.05)。多因素Logistic回归分析结果显示,饮食状况、意识障碍、NIHSS评分、洼田吞咽功能评分和荧光吞咽透视检查评分均是影响神经性吞咽障碍患者发生营养不良的独立危险因素(P<0.05)。ROC曲线显示,洼田吞咽功能评分、荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的最佳截断值分别为2.73分、4.12分,敏感度分别为87.50%、79.17%,特异性分别为76.47%、85.29%,曲线下面积(area under the curve,AUC)分别为0.800,0.835,二者联合预测的AUC为0.851,敏感度和特异性分别为79.17%和97.06%。结论神经性吞咽障碍营养不良患者的洼田吞咽功能评分和荧光吞咽透视检查评分均发生异常变化,二者可作为预测神经性吞咽障碍患者发生营养不良的敏感指标。
文摘目的:观察调神利咽针刺联合咽部冷刺激对急性脑梗死后吞咽障碍患者吞咽功能、营养状况及神经功能的影响,为临床治疗提供借鉴。方法:收集2018年1月至2019年1月收治的急性脑梗死后发生吞咽障碍的患者86例,通过随机数字表法将其分为治疗组和对照组各43例,两组均予常规西医治疗,病情稳定无进展后于入院第3天行咽部冷刺激治疗,在此基础上治疗组联合调神利咽针刺治疗,疗程均为3周。治疗前后,分别测定两组患者吞咽功能、微型营养评价(mini nutritional assessment,MNA)评分及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分,并据以判定吞咽障碍疗效、营养状况及神经功能变化。结果:治疗3周后,治疗组和对照组吞咽功能改善总有效率分别为90.70%、76.74%,差异有统计学意义(P<0.05);治疗3周后,两组MNA评分均较治疗前升高(P<0.05),且治疗组高于对照组(P<0.05),两组营养状况良好率均较治疗前升高、营养不良危险率均较治疗前降低(P<0.05),且治疗组效果优于对照组(P<0.05);治疗3周后,两组NIHSS评分均较治疗前明显降低(P<0.05),且治疗组低于对照组(P<0.05)。结论:调神利咽针刺联合咽部冷刺激可以有效改善急性脑梗死后吞咽障碍患者吞咽功能、营养状况,同时提升其神经功能,值得临床借鉴。
