《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (10): 963-966.

• 临床研究 • 上一篇    下一篇

脑卒中后病灶部位与吞咽功能的关系

张婧，杨雅琴，王春雪，赵性泉，王拥军
   

  1. 首都医科大学附属北京天坛医院神经内科，国家神经系统疾病临床医学研究中心，北京脑重大疾病研究院脑卒中研究所，北京市100050
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-10-25 发布日期:2014-10-25

Relationship between Lesion Sites of Stroke and Swallowing Function

ZHANG Jing, YANG Ya- qin, WANG Chun- xue, ZHAO Xing-quan, WANG Yong-jun.
  

  1. Neurology Department, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-10-25 Online:2014-10-25

PDF (PC)

被引次数

6

摘要： 目的明确脑卒中不同病灶部位与吞咽功能的关系。方法选取2005 年6 月~2007 年4 月间连续入住卒中单元的符合纳入标准的缺血性脑卒中患者。记录入院后患者头MRI所显示的陈旧及新卒中病灶的部位并进行分类。电视透视检查(VF)明确有无吞咽异常及误吸。分析病灶部位与吞咽障碍及误吸之间的关系。结果满足条件者共211 例，同时获得VF评估资料以及头MRI资料的患者共有169 例。159 例存在吞咽功能损伤，误吸94 例。口期异常72 例(9 例缺失)，咽期异常150 例。不同卒中病灶间出现吞咽障碍及误吸发生率无显著性差异(P>0.05)。延髓损伤有易于误吸的趋势(P=0.056)。幕上(P=0.028)和延髓以上(P=0.005)损伤容易造成口期异常。结论大脑皮质、皮质下白质、脑干及小脑的损伤，包括单侧半球损伤均可导致吞咽障碍和误吸。延髓损伤可能容易导致误吸，幕上或延髓水平以上的损伤容易造成口期异常。

关键词: 脑卒中, 损伤部位, 电视透视检查, 吞咽障碍, 误吸

Abstract: Objective To explore the relationship between lesion sites of stroke and swallowing function. Methods Ischemic stroke patients consecutively admitted into the stroke unit were screened in this study. The new and previous lesion sites of stroke, dysphagia and aspiration under videofluoroscopy (VF) were recorded and their relation was analyzed. Results 211 patients were included and 169 patients had completed the MRI and VF examination. 159 patients had dysphagia and 94 had aspiration under VF. 72 patients (9 missing) were found disorder in oral phase and 150 in pharyngeal phase. There was no significantly difference in dysphagia under VF and in aspiration among different lesion sites (P>0.05). Patients with stroke in medulla tended to happen aspiration (P=0.056). Stroke sites above the tentorium of cerebellum (P=0.028) or above medulla (P=0.005) may cause disorder in oral phase. Conclusion The stroke injury in brain cortex, white matter, brainstem and cerebellum or hemisphere could lead to dysphagia and aspiration. The injury of medulla may cause aspiration. Lesion of brain hemisphere or above the medulla could result disorder in oral phase of swallowing.

Key words: stroke, lesion site, videofluoroscopy, dysphagia, aspiration