主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (9): 1333-1337.doi: 10.3969/j.issn.1672-1756.2025.09.010

• 论著 • 上一篇    下一篇

急性期脑卒中患者吞咽障碍预后现状及影响因素分析

金晓燕 尚少梅 李硕 李丹 肖颖   

  1. 澳门科技大学医学院,999078 澳门特别行政区(金晓燕,肖颖);北京大学护理学院(尚少梅,李丹);清华大学北京清华长庚医院护理部(李硕)
  • 出版日期:2025-09-15 发布日期:2025-09-15
  • 通讯作者: 肖颖,博士,教授,课程主任,E-mail:yxiao@must.edu.mo
  • 作者简介:金晓燕,博士在读

Prognosis and influencing factors of patients with Post-Stroke Dysphagia in the acute phase

JIN Xiaoyan, SHANG Shaomei, LI Shuo, LI Dan, XIAO Ying   

  1. Faculty of Medicine, Macau University of Science and Technology, Macao, 999078, China
  • Online:2025-09-15 Published:2025-09-15
  • Contact: E-mail:yxiao@must.edu.mo

摘要: 目的:分析急性期脑卒中患者吞咽障碍的预后及其影响因素,为早期实施个性化康复护理措施提供参考。方法:便利选取2014年5月至2024年4月北京市某三级甲等医院脑卒中后吞咽障碍住院患者为研究对象,采用洼田饮水试验以及吞咽造影检查确定吞咽功能结局,利用Logistic回归分析影响患者吞咽功能预后的因素。结果:共纳入541例患者,脑卒中后2周,38.08%的患者吞咽功能恢复。回归分析结果显示:入院时格拉斯哥昏迷评分<15分(OR=0.157,95%CI:0.047~0.526)、留置鼻胃管(OR=0.002,95%CI:0~0.016),初始洼田饮水试验4级(OR=0.004,95%CI:0~0.055)和洼田饮水试验5级(OR=0.001,95%CI:0~0.016)是脑卒中后吞咽障碍预后的不利因素,入院时血清白蛋白较高(OR=1.275,95%CI:1.097~1.482)是其预后的有利因素。结论:急性期脑卒中患者吞咽障碍的预后受到患者入院时格拉斯哥昏迷评分、是否留置鼻胃管、血清白蛋白水平以及初始洼田饮水试验评分的影响。护士应早期预测患者的预后,并识别其影响因素,为患者提供针对性的康复护理措施,从而改善患者康复结局和生活质量。

关键词: 脑卒中;吞咽障碍;预后;影响因素

Abstract: Objective: To investigate the prognosis of Post-Stroke Dysphagia (PSD) in the acute phase and its influencing factors, aiming to provide a reference for early implementation of personalized rehabilitation nursing measures. Methods: Hospitalized patients with PSD in a tertiary grade A hospital in Beijing were selected by convenience sampling method from May 2014 to April 2024. The swallowing function outcome was determined by Kubota Water Swallowing Test (WST) and Videofluoroscopic Swallowing Study. Logistic regression was used to analyze the influencing factors of swallowing function prognosis. Results: A total of 541 patients were included and 38.08% of patients' swallowing function was recovered two weeks after the stroke. The results of regression analysis showed that the score of Glasgow Coma Scale (GCS)<15 (OR=0.157, 95%CI: 0.047-0.526) and nasogastric tube placement at admission (OR=0.002, 95%CI: 0-0.016), initial WST score of Grade 4 (OR=0.004, 95%CI: 0-0.055) and WST score of Grade 5 (OR=0.001, 95%CI: 0-0.016) were unfavorable factors for the prognosis of PSD, and the higher level of serum albumin (Alb) at admission (OR=1.275, 95%CI: 1.097-1.482) was a favorable factor. Conclusion: The prognosis of patients with PSD in the acute phase is influenced by the patients' score of GCS, the Alb level, nasogastric tube placement at admission, and the initial score of WST. Therefore, nurses should identify patients' prognosis and influencing factors at an early stage and provide them with targeted rehabilitative care measures to improve their rehabilitation outcomes and quality of life.

Key words: stroke; dysphagia; prognosis; influencing factor

中图分类号:  R47;R197