脑卒中患者口期和咽期吞咽功能改变与误吸的相关性：基于电视透视吞咽检查

doi:10.3969/j.issn.1006-9771.2023.08.010

Abstract

Abstract:

Objective To analyze the correlation between the changes of swallowing function and aspiration in stroke patients using videofluroscopic swallowing study.
Methods From January, 2014 to December, 2021, 240 stroke patients who underwent videofluroscopic swallowing study in the radiology department of Xuzhou Central Hospital were retrospectively analyzed. They were divided into aspiration group (n = 108, ≥ grade 5) and non-aspiration group (n = 132, < grade 5) according to Rosenbek Penetration/Aspiration Scale (PAS). The swallowing function changes in the oral and pharyngeal phases were compared between two groups according to Videofluoroscopic Dysphagia Scale, the risk factors of aspiration were analyzed using Logistic multivariate regression.
Results There were significant differences in incomplete lip closure, impaired bolus formation, apraxia, incomplete tongue-to-palate contact, premature bolus loss, prolonged oral transit time, delayed triggering of pharyngeal swallow, epiglottis folding dysfunction, pyriform sinus residue, and coating of pharyngeal wall (χ² > 5.802, P < 0.05). Prolonged oral transit time (OR = 3.964, P = 0.036), delayed triggering of pharyngeal swallow (OR = 5.684, P < 0.001), epiglottis folding dysfunction (OR = 11.571, P < 0.001) and pyriform sinus residue (OR = 4.524, P = 0.002) were correlated with aspiration.
Conclusion Prolonged oral transit time, delayed triggering of pharyngeal swallow, epiglottis folding dysfunction and pyriform sinus residue are risk factors of aspiration after stroke.

Key words: stroke, dysphagia, aspiration, videofluroscopic swallowing study

CLC Number:

R743.3

LI Zhenya, SUN Jie, GUO Pengfei, WANG Guangming. Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke patients based on videofluroscopic swallowing study[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 933-939.

Figures/Tables 4

References 35

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组别	n	性别(男/女)/n	年龄/n		卒中类型/n
组别	n	性别(男/女)/n	≥ 65岁	< 65岁	缺血	出血
误吸组	108	75/33	63	45	82	26
非误吸组	132	101/31	75	57	89	43
χ²值		1.519	0.056		2.096
P值		0.218	0.813		0.148

变量	B值	B值标准误	Wald χ²值	P值	OR值	95%CI
口唇闭合不全	0.525	0.535	0.964	0.326	1.691	0.593~4.823
食团成型障碍	-0.394	0.499	0.622	0.430	0.675	0.254~1.794
吞咽失用	-0.666	0.761	0.765	0.382	0.514	0.116~2.285
食团后漏	0.287	0.433	0.438	0.508	1.332	0.570~3.111
口腔运送时间延长	1.377	0.656	4.410	0.036	3.964	1.096~14.333
咽期吞咽启动延迟	1.738	0.383	20.558	< 0.001	5.684	2.682~12.045
会厌折返障碍	2.448	0.529	21.411	< 0.001	11.571	4.102~32.642
梨状窝残留	1.509	0.492	9.414	0.002	4.524	1.725~11.867
咽后壁残留	-0.895	0.562	2.539	0.111	0.409	0.136~1.229
常量	-2.024	0.397	26.001	< 0.001	0.132

Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke patients based on videofluroscopic swallowing study

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VDS	误吸组(n = 108)	非误吸组(n = 132)	χ²值	P值
口唇闭合不全	25	11	10.225	0.001
食团成型障碍	73	65	8.815	0.004
吞咽失用	87	88	5.802	0.016
舌与硬腭接触不全	37	21	10.914	0.001
食团后漏	37	19	13.104	< 0.001
口腔运送时间延长	81	73	10.023	0.002
咽期吞咽启动延迟	65	23	46.771	< 0.001
会厌折返障碍	52	8	56.117	< 0.001
梨状窝残留	56	30	21.913	< 0.001
咽后壁残留	38	23	9.885	0.002

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