缺血性脑卒中合并神经源性吞咽困难患者吞咽功能恢复的预测

A. A. Borzdyko, V. I. Ershov, N. V. Gumalatova, T. Lozinskaya, E. Lutsai
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引用次数: 0

摘要

目的:探讨不同病理亚型缺血性脑卒中患者吞咽功能恢复的预后特点。材料和方法。该研究纳入了110例IS急性期吞咽困难患者(男性64例,女性46例,年龄44-89岁)。采用SSS-TOAST标准诊断病理亚型,采用MASA量表判断吞咽困难的存在及严重程度。采用最小二乘法进行非线性回归,预测吞咽困难严重程度对自主进食的影响。在严重程度相当的组中,心栓塞性卒中亚型患者与动脉粥样硬化性血栓性卒中亚型患者相比,最初的特征是更大程度的吞咽困难(p<0.05)。在心脏栓塞型IS中,吞咽困难严重程度在MASA评分105 ~ 135分的组在第21天切换患者自行进食的概率低于动脉粥样硬化血栓形成型IS (p<0.05)。与动脉粥样硬化性血栓性卒中患者相比,心源性卒中患者具有更严重的初始吞咽困难和更差的吞咽功能恢复预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prediction of restoration of swallowing function in patients with ischemic stroke and neurogenic dysphagia
Objective: to determine prognostic characteristics of the restoration of swallowing function in patients with ischemic stroke (IS) of various pathogenetic subtypes.Material and methods. The study included 110 patients (64 men and 46 women aged 44–89 years) with dysphagia in the acute period of IS. The SSS-TOAST criteria were used to diagnose the pathogenetic subtype, and the MASA scale was used to determine the presence and severity of dysphagia. To predict the probability of switching to self-feeding depending on the severity of dysphagia, a non-linear regression method was used using the least squares method.Results. Patients with cardioembolic stroke subtype were initially characterized by a greater degree of dysphagia in comparison with patients with atherothrombotic stroke subtype in groups comparable in severity (p<0.05). In the cardioembolic subtype of IS, the probability of switching patients to self-feeding on the 21st day in groups with dysphagia severity from 105 to 135 points on the MASA scale was lower than in the atherothrombotic subtype of IS (p<0.05).Conclusion. Patients with cardioembolic strokes are characterized by more severe initial dysphagia and a worse prognosis for recovery of swallowing function compared to patients with atherothrombotic strokes.
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