-
精確檢索 : 冠狀病毒
-
模糊檢索 : 冠狀病毒
-
冠狀病毒感染冠狀病毒疾病
-
查詢出版品: 冠狀病毒
Read this ↓
- Journals
腦中風併吞嚥障礙患者造成吸入性肺炎及潛在性吸入之相關因子
The Correlative Factors of Aspiration Pneumonia and Silent Aspiration in Stroke Patients with Dysphagia
Abstracts
吞嚥障礙是腦中風患者常見的併發症之一。吞嚥障礙不僅會影響病人的進食功能，稍一不慎更會造成患者的吸入現象，甚至吸入性肺炎。有部分吞嚥障礙患者由於其吸入現象是屬於染在性的，患者及家屬常不易察覺，仍繼續讓患者經口進食，有冒著產生吸入性肺炎的危險而不知。所以，如何利用臨床檢查及吞嚥電視螢光錄影檢查以便早期篩選高危險病人，是處理這類病人的重要課題。 本研究回顧二年來於本部接受吞嚥評估及治療之47名腦中風患者，分析其臨床吞嚥功能及電視螢光錄影的結果，是討病人產生潛在性吸入、吸入氣象及吸入性肺炎之間的關係。希望藉此找出一些相關因子，以利早期推測高危險患者。結果發現，在47名患者中有16名(34%)有吸入性肺病史，電腦螢光錄影則有32名(68%)有吸入造影劑現象，而其中62.5%(20名)屬潛在性吸入。分析其相關因子，則發現潛在性吸入是造成吸入性肺炎的主要危險因子(=0.047)。而臨床上之嘔吐反射消失，是潛在性吸入的危險因子(=0.023)。在說話有濡溼聲的病人其電視螢光錄影易出現有吸入造影劑的情形(=0.048)。此外患者發生嗆咳、舌頭及臉部肌肉的骯肌力減退、智能減退與失言症存在，在有吸入性肺炎的病人比例都較高，但未達統計學上的意義。(慈濟醫學1996; 8:293-300)
Parallel abstracts
Dysphagia is a common and serious problem following stroke. It afflicts the feeding ability of the patients, and may result in aspiration and even aspiration pneumonia. For individuals with dysphagia, some of the aspiration happened silently. If these patients are allowed to continue oral intake, they are at the risk of aspiration pneumonia. In order to manage the patients properly, it is important to screen this group of patients using delicate clinical evaluation and videofluoroscopic examination. This study included 47 stroke patients who were referred to our department for evaluation and management of dysphagia in the past two years. We analyzed the clinical swallowing function of the patients and the results of videofluoroscopic examination and tried to define the relationship between these disorders and the occurrence of aspiration, silent aspiration as well as aspiration pneumonia. Aspiration pneumonia developed in 16 (34%) of 47 stroke patients, 32 (68%) patients revealed barium aspiration in videofluoroscopic examination, of which, 20 (62.5%) patients were silent aspiration. The results showed that silent aspiration was the only predictive factor for aspiration pneumonia(p=0.047), and absent swallowing reflex was the predictive factor for silent aspiration (p=0.023). In most conditions, the wet voice in clinical evaluation coexisted with barium aspiration in videofluoroscopic examination (p=0.048). Choking, decreased tongue or facial muscle strength, impaired mentality, and the presence of aphasia were more frequent in patients with aspiration pneumonia than in those without aspiration pneumonia, although there were no statistical significances. (Tzu Chi Med J 1996; 8: 293-300)