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目的 探讨可影响脑卒中后吞咽障碍患者预后的相关因素 ,以便为是否需要对该类患者作进一步处理 (如使用静脉营养、鼻饲或手术治疗 )提供康复临床参考。方法 选择经过规范康复治疗的吞咽障碍患者 ,记录入院时年龄、性别、病变部位、症状、体征和吞咽障碍的评定项目 ,分别使用 2 检验和多元逐步回归方程进行单因素及多因素相关性分析。结果 单因素资料分析显示 ,下列因素为吞咽障碍预后不良的危险因素 ,如入院时年龄 >70岁 (P <0 .0 1 ) ,Barthel指数 <60 (P <0 .0 1 ) ,大面积脑卒中或多部位脑卒中、脑干卒中、双侧卒中 (P <0 .0 1 ) ,合并中枢性面瘫 (P >0 .0 5) ,咽反射减弱或消失 (P >0 .0 1 )。这些患者经治疗后症状改善不明显 ,预后较差 ;而性别 (P >0 .0 5)、文化程度 (P >0 .0 5)等与不良预后关系不大。多因素logistic回归分析显示 ,吞咽障碍预后与入院时年龄、Barthel指数、脑卒中部位及程度等密切相关。结论 脑卒中患者发病及入院时资料可以协助判断吞咽障碍的预后
Objective To explore the related factors that may influence the prognosis of patients with swallowing disorders after stroke in order to provide clinical reference for the rehabilitation of these patients for further treatment (such as the use of intravenous nutrition, nasal feeding or surgical treatment). Methods Patients with dysphagia who underwent standardized rehabilitation were selected and their age, sex, location of lesion, symptoms, signs and symptoms of swallowing were recorded. Two-factor regression and multivariate stepwise regression analysis were used to analyze the correlation between single factor and multiple factors. Results The univariate analysis showed that the following factors were the risk factors for the poor prognosis of swallowing disorders such as admission age> 70 years (P <0.01), Barthel index <60 (P <0.01), large area brain Stroke or multiple stroke, brainstem stroke, bilateral stroke (P <0. 01), with central facial paralysis (P> 0.05), pharyngeal reflex diminished or disappeared (P> 0. After treatment, the symptoms of these patients did not improve obviously, and the prognosis was poor. However, the gender (P> 0.05) and education level (P> 0.05) had little relation with poor prognosis. Multivariate logistic regression analysis showed that the prognosis of swallowing disorder was closely related to the age at admission, Barthel index, stroke location and degree. Conclusion The incidence of stroke patients and admission data can help determine the prognosis of dysphagia