摘要
目的 探讨急性期吞咽障碍系统管理对后循环脑梗死预后的影响。方法 回顾性分析2010年1－12月和2012年1－12月后循环脑梗死患者203例,其中2010年98例为对照组,仅给予常规治疗及护理,2012年105例为治疗组,入院即时完成吞咽功能评估,随后进行饮食指导、吞咽训练等系统管理,观察两组间住院期间肺炎发生率、美国国立卫生研究院卒中量表（NIHSS）评分的改善值、改良Barthel生活指数（MBI）评分的改善值、住院时间、发病3个月病死率。采用χ2检验或t检验进行统计学分析。结果 对照组肺炎发生率37.8%,治疗组肺炎发生率8.6%,对照组肺炎发生率明显高于治疗组（χ2=23.62,P〈0.01）。治疗组NIHSS评分改善值、MBI评分改善值明显高于对照组（t=-6.98,P=0.001;t=-12.30,P=0.001）。对照组较治疗组住院时间明显延长（t=24.50,P=0.001）。发病3个月随访,对照组病死率6.12%,治疗组病死率0.95%,对照组病死率明显高于治疗组（χ2=8.57,P〈0.05）。结论 急性期吞咽障碍系统管理明显改善后循环脑梗死预后,减少住院期间肺炎发生率,缩短住院时间,降低病死率,应加以重视。
Objective To study the effect of the management of dysphagia on prognosis of the acute posterior circulation infarction. Methods Two hundred and three patients with dysphagia of the acute posterior circulation infarction were retrospectively analyzed and divided into two groups,98 cases in control group in 2010 year （ only routine treatment and nursing）, 105 cases in treatment group in 2012 year （swallowing assessment on admission, then dietary guidance, swallowing function training, and other management）, the incidence of pneumonia, the improved numerical of national institutes of health stroke scale （NIHSS） and modified Barthel index （ MBI）, hospital stays, mortality of 3 months between the two groups were compared.χ2 or t test were used to compare the differences of the two groups. Results The incidence of pneumonia was 37. 8% in control group and 8. 6% in treatment group, the difference between the two groups was highly significant（χ2 =23.62,P 〈0. 01 ）. There were also highly significance of the improved numerical of NIHSS and MBI （ t = - 6. 98,P = 0. 001 ; t = - 12. 30,P = 0. 001 ）, hospital stays （ t = 24. 50, P = 0. 001 ）, mortality of 3 months （χ2 = 8. 57, P 〈 0. 05 ） between the two groups. Conclusion Dysphagia system management can improve prognosis in patients with acute posterior circulation infarction, decrease the incidence of pneumonia, shorten the hospitalization time, and reduce mortality.
出处
《中华脑科疾病与康复杂志（电子版）》
2014年第5期15-18,共4页
Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）
基金
广东省医学科研基金(A2011706)
东莞市科技局科技项目(201110515001092)
关键词
吞咽障碍
脑梗死
预后
系统管理
Deglutition disorders
Brain infarction
Prognosis
System management
