脑卒中患者吞咽困难影像学异常表现与其临床表现的相关性  

Correlation between abnormal imaging manifestations of dysphagia and its clinical manifestations in stroke patients

作　　者：曾雪伟[1] 陈兴明[1] ZENG Xue-wei;CHEN Xing-ming(Department of Radiology,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院放射科,广东佛山528000

出　　处：《佛山科学技术学院学报（自然科学版）》2022年第1期68-72,共5页Journal of Foshan University(Natural Science Edition)

摘　　要：目的探讨分析脑卒中患者吞咽困难影像学异常表现与其临床表现的相关性。方法选择我院收治的70例吞咽困难的脑卒中住院患者,收治时间为2017年3月至2020年10月期间,所有患者均接受临床表现评估以及吞咽X线荧光透视检查,并对两者相关性进行探讨和分析。结果70例患者中唇闭合异常10例,舌运障碍9例,软腭运动障碍10例,咽蠕动减弱8例,声门关闭不全4例,环咽肌打开异常10例,会厌返折不全10例,以及误吸9例;经过单因素及多因素分析结果显示,食物口角露出与唇闭合异常影像表现相关,构音障碍及舌肌无力与舌运障碍影像表现相关,构音障碍与软腭运动障碍影像表现相关,进食呛咳与声门关闭不全影像表现相关,用力吞咽、进食后嗓音变化与环咽肌打开异常影像表现相关,喉上抬差、咽反射减弱与会厌返折不全影像表现相关,进食呛咳与误吸影像表现相关(P<0.05)。结论脑卒中患者的吞咽困难影响异常表现与患者在临床上的部分表现存在极为密切的相关性,因此对脑卒中患者加强吞咽X线荧光透视检查,对于预防和干预患者临床表现及加强患者临床吞咽困难治疗效果明显。Objective To explore and analyze the correlation between abnormal imaging manifestations of stroke patients with dysphagia and their clinical manifestations.Methods In this study,70 hospitalized stroke patients with dysphagia who were admitted to our hospital were selected for this study.The period of admission was from March 2017 to October 2020.All patients received clinical evaluation and swallowing X-rays,and the correlation between the two were discussed and analyzed.Results Among the 70 cases,abnormal lip closure was found in 10 cases,dyskinesia of tongue in 9 cases,movement disturbance of soft palate in 10 cases,decreased pharyngeal peristalsis in 8 cases,glottic insufficiency in 4 cases,abnormal opening of cricopharyngeal muscle in 10 cases,epiglottic regurgitation insufficiency in 10 cases,and aspiration in 9 cases.The results of univariate and multivariate analysis showed that the exposure of food mouth corners was related to abnormal lip closure,dysarthria and tongue muscle weakness were related to tongue movement disorders,dysarthria was related to soft palate movement disorders,eating cough was related to glottic insufficiency,and voice changes after hard swallowing and eating were related to abnormal images of cricopharynx muscle opening.Poor laryngeal elevation and decreased pharyngeal reflex were associated with anorexia and incomplete imaging,and eating cough was associated with aspiration(P<0.05).Conclusion The abnormal manifestation of dysphagia in patients with stroke is closely related to some clinical manifestations,so the X-ray fluoroscopy examination of dysphagia should be strengthened in stroke patients.It is effective to prevent and intervene the clinical manifestations of patients and to strengthen the treatment of clinical dysphagia.

关 键 词：脑卒中 吞咽困难 吞咽X线荧光透视检查 Logistic多因素分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]