吞咽障碍患者启动直接摄食训练的影响因素及其预测价值

林依秋; 万桂芳; 史静; 张耀文; 武惠香; 陈华玉; 温红梅

您当前的位置：

首页 >

文章列表页 >

吞咽障碍患者启动直接摄食训练的影响因素及其预测价值

临床研究 | 更新时间：2026-11-05

- 吞咽障碍患者启动直接摄食训练的影响因素及其预测价值
- 吞咽障碍患者启动直接摄食训练的影响因素及其预测价值
- 中华物理医学与康复杂志 2024年46卷第7期页码：624-627
- 作者机构：
  
  中山大学附属第三医院康复医学科,广州
- 作者简介：
- 基金信息：
  
  中山大学附属第三医院临床医学研究基金项目(YHJH201909);国家自然科学基金面上项目(82272617)
- DOI：
  中图分类号： R493
- 纸质出版：2024
- 稿件说明：
移动端阅览
林依秋, 万桂芳, 史静, 等. 吞咽障碍患者启动直接摄食训练的影响因素及其预测价值[J]. 中华物理医学与康复杂志, 2024,46(7):624-627.

林依秋, 万桂芳, 史静, et al. 吞咽障碍患者启动直接摄食训练的影响因素及其预测价值[J]. 2024, 46(7): 624-627.
林依秋, 万桂芳, 史静, 等. 吞咽障碍患者启动直接摄食训练的影响因素及其预测价值[J]. 中华物理医学与康复杂志, 2024,46(7):624-627. DOI：

林依秋, 万桂芳, 史静, et al. 吞咽障碍患者启动直接摄食训练的影响因素及其预测价值[J]. 2024, 46(7): 624-627. DOI：

摘要

目的探讨吞咽障碍患者能否启动直接摄食训练的影响因素及其预测价值。方法收集符合纳入标准的吞咽障碍患者233例

采集患者的相关信息

根据出院时的功能性经口摄食分级(FOIS)分为摄食训练组(FOIS>1)和非摄食训练组(FOIS=1)

分别进行单因素差异性分析和二元Logistic回归分析

采用受试者工作曲线(ROC)分析相关因素对是否启动摄食训练的预测价值。结果单因素分析显示

除吞咽动作外

2组患者在Rosenbek渗漏-误吸分级(PAS)、意识状态、体力耐力、肺部感染控制情况、误吸类型、自主咳嗽能力等方面组间差异均有统计学意义(P<0.05)。Logistic回归分析显示

PAS<5(OR=21.064

P<0.001)、体力耐力可(半坐卧位或坐位可坚持30 min及以上)、肺部感染控制、有自主咳嗽能力可能是启动直接摄食训练的指征(P<0.05)。ROC分析显示

PAS分级预测启动直接摄食训练的ROC曲线下面积(AUC)为0.752(P<0.001)

其余三项单独指标AUC均<0.7

而PAS分级、体力耐力、肺部感染控制情况及自主咳嗽能力四项指标联合的AUC为0.870(P<0.001)

敏感度为84.9%

特异度为77.1%。结论吞咽障碍的误吸情况(PAS分级)、体力耐力、肺部感染控制情况及自主咳嗽能力可能是患者启动直接摄食训练的影响因素

上述指标对启动直接摄食训练有较好的预测作用

且这4项指标联合的预测效果优于各单项指标预测效果。

Abstract

关键词

Keywords

references

臧全雪.探讨早期标准化康复护理联合摄食训练在脑卒中伴吞咽障碍患者中的运用[J].中国标准化,2022(10).

刘慈花,林慈宽,陈娟.早期摄食功能训练对脑卒中吞咽障碍患者康复效果的影响[J].中西医结合护理(中英文),2021(11).

魏英玲,刘忠良,段晓琴.卒中单元患者摄食-吞咽障碍的预后因素分析[J].中国康复医学杂志,2010(04).

吞咽障碍评估与治疗[M].人民卫生出版社,2017.

Smith Rebecca,Bryant Lucy,Hemsley Bronwyn.The true cost of dysphagia on quality of life: The views of adults with swallowing disability.[J].International journal of language & communication disorders,2022.

Speyer Renée,Cordier Reinie,Farneti Daniele,Nascimento Weslania,Pilz Walmari,Verin Eric,Walshe Margaret,Woisard Virginie.White Paper by the European Society for Swallowing Disorders: Screening and Non-instrumental Assessment for Dysphagia in Adults.[J].Dysphagia,2021.

Sato Shinichi,Hidetoshi Takahashi.Assessment of the risk of malnutrition due to aspiration pneumonia and oral feeding difficulty.[J].Nutricion hospitalaria,2020.

Department of Morphological Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Health Sciences Postgraduate Course, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil..Adult Swallowing Disorders: Focus on Quality of Life.[J].International archives of otorhinolaryngology,2019.

Irene Calvo,Nicole Pizzorni,Giulia Gilardone,Flavia Mayer,Nicola Vanacore,Valentina Buraschi,Marco Gilardone,Massimo Corbo.Predictors of Oral Feeding Resumption after Stroke in a Rehabilitation Hospital: A Retrospective Study[J].Journal of Stroke and Cerebrovascular Diseases,2019.

Marian Galovic,Anne Julia Stauber,Natascha Leisi,Werner Krammer,Florian Brugger,Jochen Vehoff,Philipp Balcerak,Anna Müller,Marlise Müller,Jochen Rosenfeld,Alexandros Polymeris,Sebastian Thilemann,Gian Marco De Marchis,Thorsten Niemann,Maren Leifke,Philippe Lyrer,Petra Saladin,Timo Kahles,Krassen Nedeltchev,Hakan Sarikaya,Simon Jung,Urs Fischer,Concetta Manno,Carlo W. Cereda,Josemir W. Sander,Barbara Tettenborn,Bruno J. Weder,Sandro J. Stoeckli,Marcel Arnold,Georg Kägi.Development and Validation of a Prognostic Model of Swallowing Recovery and Enteral Tube Feeding After Ischemic Stroke[J].JAMA Neurology,2019.

School of Food and Nutrition, Massey University, Auckland, New Zealand.,School of Food and Nutrition, Massey University, Auckland, New Zealand.,Department of Surgery, University of Auckland, Auckland, New Zealand.,School of Food and Nutrition, Massey University, Auckland, New Zealand..High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital.[J].Nutrition & dietetics: the journal of the Dietitians Association of Australia,2018.

Janina Wilmskoetter,Teri Lynn Herbert,Heather S. Bonilha.Factors Associated With Gastrostomy Tube Removal in Patients With Dysphagia After Stroke[J].Nutrition in Clinical Practice,2017.

Akie Nakadate,Yohei Otaka,Kunitsugu Kondo,Ruka Yamamoto,Daisuke Matsuura,Kaoru Honaga,Kaori Muraoka,Kazuto Akaboshi,Meigen Liu.Age, Body Mass Index, and White Blood Cell Count Predict the Resumption of Oral Intake in Subacute Stroke Patients[J].Journal of Stroke and Cerebrovascular Diseases,2016.

Takizawa Claire,Gemmell Elizabeth,Kenworthy James,Speyer Renée.A Systematic Review of the Prevalence of Oropharyngeal Dysphagia in Stroke, Parkinson's Disease, Alzheimer's Disease, Head Injury, and Pneumonia.[J].Dysphagia,2016.

Hoffmann Sarah,Malzahn Uwe,Harms Hendrik,Koennecke Hans-Christian,Berger Klaus,Kalic Marianne,Walter Georg,Meisel Andreas,Heuschmann Peter Ulrich.Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke.[J].Stroke,2012.

Guntram W. Ickenstein,Carolin Höhlig,Mario Prosiegel,Horst Koch,Rainer Dziewas,Ulf Bodechtel,Rainer Müller,Heinz Reichmann,Axel Riecker.Prediction of Outcome in Neurogenic Oropharyngeal Dysphagia within 72 Hours of Acute Stroke[J].Journal of Stroke and Cerebrovascular Diseases,2012.

Emma Osland,Rossita Mohamad Yunus,Shahjahan Khan,Muhammed Ashraf Memon.Early Versus Traditional Postoperative Feeding in Patients Undergoing Resectional Gastrointestinal Surgery[J].Journal of Parenteral and Enteral Nutrition,2011.

Crary Michael A,Mann Giselle D Carnaby,Groher Michael E.Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients.[J].Archives of physical medicine and rehabilitation,2005.

Rosenbek J C,Robbins J A,Roecker E B,Coyle J L,Wood J L.A penetration-aspiration scale.[J].Dysphagia,1996.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

直接摄食训练对脑卒中吞咽障碍患者吞咽功能恢复的影响

非侵入性脑刺激技术在脑卒中后吞咽障碍康复中的应用和研究进展

多模态精准营养干预对卒中后吞咽障碍患者功能恢复的影响

中药四味冰棒联合常规吞咽训练对脑梗死后恢复期口咽期吞咽障碍的影响

经皮耳迷走神经刺激对脑卒中后吞咽障碍患者吞咽功能的影响