脑卒中吞咽障碍患者安全进食行为及影响因素研究  

Safe eating behaviour and influencing factors in patients with dysphagia after stroke

作　　者：冯晓瑜[1] 黎静雯 张咏军 叶慧玲[1] FENG Xiao-yu;LI Jing-wen;ZHANG Yong-jun;YE Hui-ling(Department of General Practice,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510120,China;不详)

机构地区：[1]广州医科大学附属第一医院全科医学科,广东广州510120 [2]广州医科大学附属第一医院神经内科

出　　处：《中华全科医学》2023年第2期333-336,共4页Chinese Journal of General Practice

基　　金：广东省中医药局中医药科研项目(20212128);广州市卫生健康科技一般引导项目(20201A011071)。

摘　　要：目的 通过分析脑卒中吞咽障碍患者安全进食行为,探讨其影响因素,为临床提供参考,重视吞咽障碍患者的进食行为。方法 采用方便抽样法选取2019年1月-2020年12月在广州医科大学附属第一医院诊断为脑卒中吞咽障碍的患者为调查对象,采用一般资料调查表,包括社会人口学资料及疾病相关资料,脑卒中吞咽障碍患者安全进食行为评价量表、安全进食知识问卷收集资料并进行安全进食行为状况描述及多元逐步回归分析。结果 本研究共纳入176例脑卒中吞咽障碍患者,单因素分析显示,不同文化程度、婚姻状况、是否发生过吸入性肺炎、语言障碍情况、吞咽治疗情况、Barthel指数、洼田饮水试验分级的安全进食行为比较,差异有统计学意义(均P<0.05);多元逐步回归分析显示,Barthel指数、安全进食知识总分、吞咽治疗情况与患者安全进食行为呈正相关关系(均P<0.05),语言障碍、是否发生吸入性肺炎与安全进食行为水平呈负相关关系(均P<0.05),5个变量的多元相关系数R=0.647,回归的R2=0.419,调整的R2=0.402。结论 多种因素影响脑卒中吞咽障碍患者的安全进食行为,Barthel指数、安全进食知识总分、吞咽治疗情况、语言障碍、是否发生吸入性肺炎是独立影响因素。Objective The safe eating behaviour of patients with dysphagia after stroke was analysed to determine influencing factors and provide reference for clinical practice and pay attention to the eating behaviour of patients with dysphagia. Methods Convenience sampling was conducted to select patients with stroke and dysphagia from January 2019 to December 2020 in the First Affiliated Hospital of Guangzhou Medical University. The general information questionnaire including sociodemographic data and disease related data, stroke dysphagia patient safe eating behaviour evaluation scale and safe eating knowledge questionnaire were used to collect data and conduct safety description of eating behaviour and multiple stepwise regression analysis. Results A total of 176 stroke patients with swallowing disorders were included. Univariate analysis showed significant differences in safe eating behaviour among patients with different education levels, marital statuses, aspiration pneumonia, language disorder, swallowing treatment, Barthel Index and safe eating behaviour in Watian drinking water test(all P<0.05). Multivariate stepwise regression analysis showed that Barthel index, total score of safe eating knowledge and swallowing treatment were positively correlated with safe eating behaviour(all P<0.05), while language disorder and aspiration pneumonia were negatively correlated with safe eating behaviour(all P<0.05). The multiple correlation coefficient of the five variables was r=0.647, the regression R~2 was 0.419 and the adjusted R~2 was 0.402. Conclusion A variety of factors affect the safe eating behaviour of stroke patients with dysphagia. Barthel index, total score of safe eating knowledge, swallowing treatment, language disorder and diagnosis of inhalation pneumonia are independent influencing factors.

关 键 词：脑卒中 吞咽障碍 进食行为 影响因素 

分 类 号：R74.3[医药卫生—神经病学与精神病学]