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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Oropharyngeal dysphagia after stroke: incidence, diagnosis, and clinical predictors in patients admitted to a neurorehabilitation unit.
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Oropharyngeal dysphagia after stroke: incidence, diagnosis, and clinical predictors in patients admitted to a neurorehabilitation unit.

机译：脑卒中后口咽部吞咽困难：神经康复科患者的发病率，诊断和临床预测指标。

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OBJECTIVE: We analyzed patients with stroke in a neurorehabilitation unit to define incidence of dysphagia, compare clinical bedside assessment and videofluoroscopy (VFS), and define any correlation between dysphagia and clinical characteristic of patients. METHODS: In all, 151 consecutive inpatients with recent ischemic or hemorrhagic stroke were enrolled. RESULTS: Dysphagia was clinically diagnosed in 62 of 151 patients (41%). A total of 49 patients (79% of clinically dysphagic patients) underwent VFS. Six patients clinically suggested to be dysphagic had a normal VFS finding. The correlation between clinical and VFS diagnosis of dysphagia was significant (r = 0.6505). Penetrations and aspirations were observed, respectively, in 42.8% and 26.5% of patients with dysphagia, with 12.2% classified as silent. Lower respiratory tract infections were observed in 5.9%, more frequently in patients with dysphagia (30%). Dysphagia was not influenced by type of stroke. Cortical stroke of nondominant side was associated with dysphagia (P = .0322) and subcortical nondominant stroke showed a reduced frequency of dysphagia (P = .0008). Previous cerebrovascular disease resulted associated to dysphagia (P = .0399). Patients with dysphagia had significantly lower functional independence measurement (FIM) and level of cognitive functioning on admission and lower FIM on discharge, longer hospital stay, and more frequent malnutrition, and they were more frequently aphasic and dysarthric. Percutaneous endoscopic gastrostomy was used in 18 of 151 patients (11.9%) (41.8% of patients with VFS-proved dysphagia). CONCLUSIONS: Dysphagia occurs in more than a third of patients with stroke admitted to rehabilitation. Clinical assessment demonstrates good correlation with VFS. The grade of dysphagia correlates with dysarthria, aphasia, low FIM, and level of cognitive functioning. Large cortical strokes of nondominant side are associated with dysphagia.
机译：目的：我们在神经康复科对中风患者进行了分析，以确定吞咽困难的发生率，比较临床床旁评估和荧光透视（VFS），并确定吞咽困难与患者临床特征之间的任何相关性。方法：总共纳入了151名近期缺血性或出血性中风的住院患者。结果：151例患者中有62例临床诊断为吞咽困难（41％）。共有49例患者（占临床上吞咽困难患者的79％）接受了VFS。临床上建议有吞咽困难的六名患者的VFS发现正常。吞咽困难的临床诊断与VFS诊断之间具有显着相关性（r = 0.6505）。吞咽困难的患者分别有42.8％和26.5％的渗透率和误吸率，其中12.2％被归为沉默型。吞咽困难的患者中下呼吸道感染的发生率为5.9％，更常见（30％）。吞咽困难不受中风类型的影响。皮质侧非支配性卒中与吞咽困难有关（P = .0322），皮质侧非支配性卒中显示出吞咽困难的频率降低（P = .0008）。先前的脑血管疾病导致吞咽困难（P = .0399）。吞咽困难的患者入院时的功能独立性测量（FIM）和认知功能水平显着降低，出院时的FIM较低，住院时间更长，营养不良的发生频率也更高，并且他们的无意识和营养不良频率更高。 151例患者中的18例（11.9％）（经VFS证实的吞咽困难的患者为41.8％）使用了经皮内镜胃造口术。结论：吞咽困难发生在接受康复治疗的中风患者的三分之一以上。临床评估表明与VFS有良好的相关性。吞咽困难的程度与构音障碍，失语症，低FIM和认知功能水平相关。非优势侧的大皮质卒中与吞咽困难有关。

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