联合脉搏血氧监测法评估急性卒中误吸风险临床价值研究  

Water swallow test associated with oxygen saturation monitoring in accessing aspiration after acute stroke

作　　者：李巍[1] 孟然[1] 李占元[1,2] 张彤[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038 [2]中国人民解放军白求恩国际和平医院256临床部,石家庄050800

出　　处：《中国实用内科杂志》2011年第9期700-702,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家自然基金面上项目(30770741);北京市卫生系统高层次卫生技术人才项目(2009-03-02)

摘　　要：目的探讨联合脉搏血氧监测法对急性卒中误吸风险的评估价值。方法选择2005年4月至2007年7月首都医科大学附属北京世纪坛医院连续收治的急性脑卒中患者117例。急性脑卒中患者入院后24 h内分别按普通检查法(颅神经检查和洼田饮水试验)及联合脉搏血氧监测法(颅神经检查、洼田饮水试验联合同步的脉搏血氧监测法)评估患者的误吸风险。结果联合脉搏血氧监测法发现存在误吸风险的患者47例(40.2%),常规检查法为25例(21.4%),该方法评估误吸风险的比率明显高于普通检查法(P<0.01)。联合脉搏血氧监测法预测吸入性肺炎的敏感度是82.4%,普通检查法预测吸入性肺炎的敏感度是41.2%,两种方法的敏感度比较差异有统计学意义(P=0.001)。结论联合脉搏血氧监测法是一种评估误吸和吸入性肺炎风险的敏感方法。Objective To evaluate the value of water swallow test associated with oxygen saturation monito- ring in accessing aspiration after acute stroke. Methods 117 acute stroke patients admitted to our hospital be- tween April 2005 and July 2007 were enrolled. The risk of aspiration in the 117 patients was assessed with the rou- tine method （cranial nerve examination, water swallow test） and the combination of water swallow test and oxygen saturation monitoring （ cranial nerve examination, the combination of water swallow test and oxygen saturation mo- nitoring） within 24 hours on admission. Results 47 cases （40. 2% ） were with aspiration risk in the combination of water swallow test and oxygen saturation monitoring;while 25 cases （21.4%） were noted with aspiration risk under the routine method; this indicates that the ratio of aspiration risk achieved by combination method was signif- icantly higher than the routine method （ P 〈 0. 001 ）. The sensitivity on predicting aspiration pneumonia in the combination of water swallow test and oxygen saturation monitoring method was 82.4% , and that of the routine method was 41.2%, statistical significance of sensitivity was noted between both methods （P = 0. 001 ）. Conclusion Combination of water swallow test and oxygen saturation monitoring may be used in evaluating the aspiration risk and aspiration pneumonitis of patients with stroke.

关 键 词：急性卒中 误吸 脉搏血氧饱和度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]