中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2018, Vol. 13 ›› Issue (12): 2156-2159.doi: 10.4103/1673-5374.241466

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

双侧脑桥梗死并高功能性残疾患者发生吞咽困难风险高

  

  • 收稿日期:2018-07-12 出版日期:2018-12-15 发布日期:2018-12-15

Dysphagia in patients with isolated pontine infarction

Min Cheol Chang1, Sang Gyu Kwak2, Min Ho Chun3   

  1. 1 Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
    2 Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
    3 Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
  • Received:2018-07-12 Online:2018-12-15 Published:2018-12-15
  • Contact: Min Ho Chun, MD, mhchun0@gmail.com.

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摘要：

以往对脑桥梗死后吞咽困难的研究，多关注的是临床特征，本次研究拟评估孤立性脑桥梗死后吞咽困难的发生率，并确定吞咽困难发生的预测因素。研究共纳入146例脑桥梗死患者，对比单侧与双侧脑桥梗死患者的吞咽困难发生率。50例（34.2％）在入院后1天内出现吞咽困难；在出院时的第2次评估中，24例患者（16.4％）发生吞咽困难。双侧脑桥梗死患者更容易出现吞咽困难。同时，在患者入院后1天内改良Rankin量表（mRS）评分和国立卫生研究院卒中量表（NIHSS）评分评估的临床严重程度被确定为孤立性脑桥梗死患者吞咽困难的预测因子（多重二元logistic回归分析，mRS：P = 0.011，NIHSS：P = 0.004），较高的NIHSS和mRS评分预示吞咽困难发展的风险较高。因此，作者认为临床医生应特别注意孤立性脑桥梗死患者易发生吞咽困难，尤其是双侧脑桥梗死或高功能残疾患者。

orcid:0000-0001-8666-7225(Min Ho Chun)

 

关键词: 吞咽困难, 脑桥, 梗死, 脑卒中, 预测

Abstract:

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.

Key words: dysphagia, pons, infarction, stroke, prediction, NIHSS score, MRS score