老年脑卒中住院患者吞咽体验与衰弱和营养状况的相关性

doi:10.3969/j.issn.1006-9771.2020.11.004

Abstract

Abstract:

Objective To investigate the relationship of swallowing experience to frailty and nutrition in old stroke inpatients.Methods From March to July, 2019, 174 stroke inpatients aged above 60 were investigated with Dysphagia Handicap Index (DHI), FRAIL Scale and Mini Nutritional Assessment Short Form (MNA-SF). The correlation of DHI score to scores of FRAIL Scale and MNA-SF was analyzed with Pearson correaltion analysis. Multiple regression was analyzed using the scores of dimensions and total score of DHI as dependent variables, and the scores of FRAIL Scale and MNA-SF as independent variables.Results The inpatients aged (76.16±9.908) years. The DHI score was (50.34±28.325), in which the body score was (17.68±10.254), the function score was (20.31±11.085) and the emotion score was (12.36±9.193). The FRAIL Scale score was (3.16±1.301), and the MNA-SF score was (8.95±2.529). The DHI scores positively correlated with the FRAIL Scale score (r = 0.575, P< 0.001) and negatively correlated with the MNA-SF score (r = -0.544, P< 0.001). The scores of FRAIL Scale and MNA-SF explained the 34.4% of variable for body, 38.7% for function, 36.1% for emotion and 42.4% for DHI total score.Conclusion Improving the frailty and nutrition may reduce the poor swallowing experience for old stroke inpatients.

Key words: stroke, aged, swallowing experience, frailty, nutrition

CLC Number:

R743.3

QI Bei,ZHANG Zhen-xiang,WANG Yong-li,FU Bo,GUO Ya-wen. Correlation of Swallowing Experience to Frailty and Nutrition in Old Stroke Inpatients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(11): 1269-1275.

Figures/Tables 5

因变量	自变量	B	SE	$β$	t值	P值	R²	ΔR²	F值	P值
身体维度	衰弱情况	2.590	0.546	0.329	4.745	< 0.001	0.352	0.344	46.365	< 0.001
	营养状况	-1.482	0.281	-0.366	-5.277	< 0.001
功能维度	衰弱情况	3.532	0.571	0.415	6.190	< 0.001	0.394	0.387	55.532	< 0.001
	营养状况	-1.394	0.294	-0.318	-4.749	< 0.001
情感维度	衰弱情况	2.872	0.483	0.406	5.943	< 0.001	0.368	0.361	49.816	< 0.001
	营养状况	-1.096	0.249	-0.301	-4.408	< 0.001
DHI总分	衰弱情况	8.994	1.413	0.413	6.364	< 0.001	0.431	0.424	64.647	< 0.001
	营养状况	-3.972	0.727	-0.355	-5.463	< 0.001

References 24

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项目	组别	n
年龄(岁)	60~69	58
	70~79	43
	80~89	61
	> 90	12
性别	男	106
	女	68
文化程度	小学及以下	36
	初中	34
	高中或中专	35
	大专及以上	69
每月经济收入	不能维持收支平衡	37
	大体能够维持收支平衡	55
	足够维持收支平衡	82
宗教信仰	无宗教信仰	150
	有宗教信仰	24
婚姻状况	已婚	167
	离婚	2
	丧偶	5
首次发病时间距今(年)	< 1	56
	1~3	52
	4~7	47
	8~10	9
	> 10	10
是否患有其他慢性病	是	138
	否	36
卒中类型	脑梗死	135
	脑出血	13
	混合型	26
卒中次数	1~2	148
	3~4	22
	5~7	4
医疗付费形式	公费	5
	医保	121
	新农合	39
	自费	9
是否存在吞咽障碍	是	99
	否	75

维度	条目	得分
身体		17.68±10.254
	P1我在喝水、牛奶、汤、饮料等流质食物时会发生呛咳	1.94±1.417
	P2我在吃米饭、馒头、蔬菜、肉等固体食物时会发生呛咳	1.34±1.461
	P3我觉得口干	2.37±1.378
	P4进食时需靠水、汤、牛奶、饮料等液体来冲服,否则难以吞咽	2.31±1.465
	P5我因为吞咽问题导致体质量下降	2.11±1.501
	P6我需要反复多吞几次才能将食物咽下去	2.25±1.484
	P7我吃药的时候会噎住	2.13±1.553
	P8 我吞咽的时候有无法呼吸的感觉	1.54±1.557
	P9 我吞咽后会咳出食物	1.68±1.606
功能		20.31±11.085
	F1我因为吞咽问题拒绝吃某些食物	2.15±1.474
	F2我通过改变吞咽方式来方便进食	2.32±1.547
	F3 我吃一顿饭花的时间比以往长	2.85±1.330
	F4我因为吞咽问题而更多地采用少食多餐的方式进食	1.99±1.700
	F5 我因为吞咽问题而减少了社交活动	2.24±1.613
	F6我因为吞咽问题而不想吃东西	2.14±1.603
	F7 我因为吞咽问题吃得更少了	2.28±1.448
	F8 我因为吞咽问题必须改变进食方式(如通过管喂)	2.00±1.720
	F9 我因为吞咽问题改变了自己的膳食	2.34±1.496
情感		12.36±9.193
	E1我觉得跟亲朋好友在外就餐很尴尬	1.78±1.601
	E2我觉得不能吃自己想吃的食物是件挺令人难过的事情	2.21±1.567
	E3我不像以前那样享受吃东西了	2.29±1.516
	E4 我因为吞咽问题而感到焦虑	1.71±1.561
	E5我因为吞咽问题而觉得自己像个残疾人了	1.78±1.630
	E6我因为吞咽问题对自己生气	1.30±1.548
	E7我因为吞咽问题害怕有一天会哽噎甚至无法呼吸	1.29±1.550
总分		50.34±28.325

吞咽情况	n	身体维度	功能维度	情感维度	DHI总分
存在吞咽障碍	99	23.92±8.071	27.27±7.696	17.98±7.237	69.17±19.485
不存在吞咽障碍	75	9.44±6.217	11.12±7.642	4.93±5.485	25.49±16.516
t值		13.367	13.752	13.527	15.620
P值		< 0.001	< 0.001	< 0.001	< 0.001

Correlation of Swallowing Experience to Frailty and Nutrition in Old Stroke Inpatients

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DHI	FRAIL量表	MNA-SF	P值
身体维度	0.496	-0.516	< 0.001
功能维度	0.560	-0.508	< 0.001
情感维度	0.544	-0.487	< 0.001
总分	0.575	-0.544	< 0.001

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