摘要
目的探讨项丛刺疗法对脑卒中吞咽障碍患者康复预后影响的相关因素。方法选择符合入组标准的140例脑卒中吞咽障碍患者,均接受项丛刺疗法治疗,根据出院时吞咽功能评定改善情况分为预后良好组及预后不良组;对可能影响吞咽障碍康复预后的因素做单因素分析和多因素Logistic回归分析。结果单因素分析显示,年龄、卒中类型、病变部位、发病时间、入院洼田评定等级5个因素为影响项丛刺疗法治疗吞咽障碍康复的危险因素(P<0.05);首次将吞咽障碍预后与临床重大伴随疾病进行单因素分析,提示吞咽障碍患者预后与高血压、冠心病、2型糖尿病、心律失常房颤、血脂异常等重大疾病无关,而与肺炎相关,且预后差(P<0.05)。多因素分析示,发病时间、治疗时间、入院洼田评定等级是影响项丛刺疗法治疗吞咽障碍患者预后的独立危险因素(P<0.05)。对成功拔鼻饲管患者进行多重线性回归分析,发病时间、治疗时间是影响项丛刺疗法对拔管患者预后的独立危险因素(P<0.1)。结论年龄、卒中类型、病变部位、发病时间、入院洼田评定等级、治疗时间、有无肺炎为影响项丛刺疗法治疗吞咽障碍康复的危险因素,可协助判断预后。
Objective To explore the related factors affecting the prognosis of dysphagia after stroke by using nape-aligned acupuncture therapy.Methods 140 patients with stroke and dysphagia who met the enrollment criteria were selected according to their swallowing function improvement at the time of discharge.The patients who all used nape-aligned acupuncture therapy were divided into two groups with good prognosis and poor prognosis.Factors that could influence the prognosis of dysphagia after stroke were done univariate analysis and multivariate logistic regression analysis.Results Univariate analysis showed age,type of stroke,diseased region,disease time,water swallow test were risk factors for dysphagia in patients with rehabilitation(P<0.05).Univariate analysis also for the first time showed that the prognosis of dysphagia patients was related to SAP,not to hypertension,coronary disease,diabetes,atrial fibrillation,abnormal blood lipid level and other serious diseases.Multivariate logistic regression showed that disease time,time of therapy,water swallow test were independent risk factors for swallowing rehabilitation(P<0.05).For patients off nasogastric feeding tube,multiple linear regression showed that disease time,time of therapy were independent risk factors for swallowing rehabilitation using nape-aligned acupuncture therapy(P<0.1).Conclusion Age,type of stroke,diseased region,disease time,water swallow test,SAP are important factors influencing rehabilitation of dysphagia after stroke,which can help to predict prognosis.
作者
高佳秀
周鸿飞
GAO Jiaxiu;ZHOU Hongfei(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated•Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2020年第3期143-146,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
辽宁省科技厅项目(2013226012)
辽宁省教育厅项目(L201627)。
关键词
吞咽障碍
项丛刺
康复
预后
单因素分析
多因素分析
独立危险因素
dysphagia
nape-aligned acupuncture therapy
rehabilitation
prognosis
univariate analysis
multifactor analysis
independent risk factors
