脑肿瘤切除术患者发生获得性吞咽功能障碍的危险因素分析  

Risk factors of acquired swallowing dysfunction in patients undergoing brain tumor resection

作　　者：张璐 于蕾 曾莉[3] 李荣青 陈丹丹 Zhang Lu;Yu Lei;Zeng Li;Li Rongqing;Chen Dandan(Neurosurgery Department,Taicang First People's Hospital of Jiangsu Province,Suzhou 215400,China;Department of Anesthesiology,Shanghai East Hospital of Tongji University,Shanghai 200120,China;Neurosurgery Department,Tenth People's Hospital of Tongji University,Shanghai 200072,China;Department of Cerebrovascular Diseases,Changhai Hospital,the Second Military Medical University,Shanghai 200433,China)

机构地区：[1]江苏省太仓市第一人民医院神经外科,苏州215400 [2]同济大学附属东方医院麻醉科,上海200120 [3]同济大学附属第十人民医院神经外科,上海200072 [4]海军军医大学附属长海医院脑血管病内科,上海200433

出　　处：《中华现代护理杂志》2021年第20期2691-2696,共6页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金委员会资助项目(青年科学基金项目)(72004162)。

摘　　要：目的:探讨脑肿瘤术后入ICU患者获得性吞咽功能障碍的发生情况,并分析患者发生获得性吞咽功能障碍的危险因素。方法:通过便利抽样的方法选取2018年5月—2019年12月上海市某三级甲等医院脑肿瘤术后入ICU的147例患者为研究对象,收集相关临床资料,应用单因素分析和多因素Logistic回归分析探讨患者获得性吞咽功能障碍发生的危险因素。结果:147例脑肿瘤术后入ICU患者获得性吞咽功能障碍的发生率为21.1%(31/147)。Logistic回归分析结果显示,格拉斯哥昏迷量表(GCS)评分(OR=0.573,95%CI:0.457~0.719)、胃肠营养管置管(OR=15.381,95%CI:2.698~87.700)和肿瘤部位(OR=6.264,95%CI:2.662~14.739)是脑肿瘤术后入ICU患者获得性吞咽功能障碍发生的独立预测因子(P<0.01)。结论:脑肿瘤术后入ICU患者获得性吞咽功能障碍的发生率较高,危险因素较多,有幕下肿瘤、胃肠营养管置管、低GCS评分,应对高危人群密切关注,以便采取早期措施预防获得性吞咽功能障碍的发生。Objective To explore the incidence of acquired swallowing dysfunction in Intensive Care Unit(ICU)patients after brain tumor surgery,and analyze the risk factors of patients with acquired swallowing dysfunction.Methods From May 2018 to December 2019,convenience sampling was used to select 147 patients who were admitted to the ICU after brain tumor surgery in a ClassⅢGrade A hospital in Shanghai as the research object and clinical data were collected.Single factor analysis and multivariate Logistic regression analysis were used to analyze the risk factors of acquired swallowing dysfunction.Results The incidence of acquired swallowing dysfunction in 147 patients admitted to ICU after brain tumor surgery was 21.1%(31/147).Logistic regression analysis showed that the Glasgow Coma Scale(GCS)score[OR=0.573,95%CI(0.457,0.719)],gastrointestinal nutrition tube placement[OR=15.381,95%CI(2.698,87.700)]and tumor location[OR=6.264,95%CI(2.662,14.739)]were independent predictors of acquired swallowing dysfunction in ICU patients after brain tumor surgery(P<0.05).Conclusions The incidence of acquired swallowing dysfunction in ICU patients after brain tumor surgery is high,and there are many risk factors,such as infratentorial tumors,placement of gastrointestinal feeding tubes,and low GCS scores.High-risk groups should be closely watched so that early measures can be taken to prevent the occurrence of acquired swallowing dysfunction.

关 键 词：脑肿瘤 吞咽障碍 重症监护 危险因素 神经外科 

分 类 号：R739.41[医药卫生—肿瘤]