缺血性脑卒中后伴吞咽困难患者的睡眠呼吸紊乱的初步研究  

Preliminary Study of Nocturnal Breathing Disturbance in Patients of Ischemic Cerebral Stroke with Dysphagia

作　　者：张维[1] 张杰[2] 柳开忠[1] 

机构地区：[1]浙江省肿瘤医院重症监护室,浙江杭州市310022 [2]北京天坛医院呼吸内科,北京市100050

出　　处：《中国康复理论与实践》2008年第1期57-59,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的在首次发作脑梗死的患者中,分析吞咽困难在睡眠呼吸暂停发生过程中的作用。方法通过电视透视检查,将50例脑梗死患者分为吞咽困难组和非吞咽困难组两组,比较梗死部位、梗死严重程度对呼吸紊乱的影响,探讨吞咽困难在睡眠呼吸暂停中的可能作用。结果吞咽困难组在急性期的阻塞性事件最为突出(呼吸暂停低通气指数AHI20.9次/h;阻塞性呼吸暂停指数OAI19.1),非吞咽困难组的呼吸暂停事件明显减少(AHI9.5次/h,OAI8.6)。多元相关性分析显示,吞咽困难的严重程度与AHI和OAI有一定的相关性(AHI,P=0.018;OAI,P=0.024)。结论脑梗死患者急性期出现的阻塞性事件的数量和类型,与神经系统损伤后继发的咽喉部肌肉功能紊乱有关。Objective To analyze the role of dysphagia during the course of sleep apnea in patients who experienced a first-ever ischemic stroke. Methods According to the video fluoroscopy, 50 patients were divided into two groups： dysphagia and non-dysphagia groups. The effect of different sites and severity of infarction on the breathing disturbance was analyzed, and the possible role of dysphagia was discussed. Results Patients with dysphagia showed more number of OAIs at the acute phase （AHI, 20.9; OAI, 19.1） than that of non-dysphagic patients （AHI, 9.5; OAI, 8.6）. Multiple correlation analysis found the extent of dysphagia had relationship with the AHI, especially OAI （AHI, P=0. 018; OAI, P=0. 024）. Conclusion The number and type of obstructive apneic events may occur at the acute phase of a first-ever cerebral infarction in patients with pharyngeal muscle alterations secondary to the neurological lesion.

关 键 词：吞咽困难 脑梗死 睡眠呼吸暂停低通气综合症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]