| 陆蓉蓉,何志杰,吴军发,白玉龙,吴毅,陈颖.气管切开的慢性意识障碍患者吞咽功能结局影响因素分析[J].中国康复,2024,39(8):470-474 |
| 气管切开的慢性意识障碍患者吞咽功能结局影响因素分析 |
| Factors influencing swallowing outcome in prolonged disorders of consciousness patients with tracheostomy |
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| DOI：10.3870/zgkf.2024.08.005 |
| 中文关键词: 吞咽障碍 意识障碍 气管切开 获得性脑损伤 |
| 英文关键词: swallowing impairment disorders of consciousness tracheostomy acquired brain injury |
| 基金项目:国家重点研发计划（2022YFC3601204） |
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| 摘要点击次数: 1967 |
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| 中文摘要: |
| 目的：探究影响严重脑损伤所致意识障碍伴气管切开的患者吞咽功能恢复的因素。方法：本研究回顾性收集脑损伤后存在气管切开的意识障碍患者的病史资料。包括入院时的人口统计学特征、昏迷恢复量表修订版（CRS-R）评分、格拉斯哥昏迷量表（GCS）评分、改良染料试验（MEBDT）结果、气切置管时间和功能性经口摄食量表（FOIS）评分。本研究最终纳入141例受试者，并在1年时进行随访，根据随访1年时的FOIS评估，将患者分为吞咽功能差（FOIS分级1～3级）71例和吞咽功能好（FOIS分级4～7级）70例，收集气管拔管情况、GCS评分和FOIS评分。138例受试者的结果纳入最终分析。应用Logistic回归分析评价各因素与吞咽功能恢复的相关性。结果：吞咽功能好组拔管率高于吞咽功能差组（P＜0.01），吞咽功能好组GCS≥8分的比率高于吞咽功能差组（P＜0.05）。根据Logistic回归分析，MEBDT、1年内拔除气切套管、1年时的GCS评分对1年时吞咽功能恢复影响显著（P＜0.05,0.01）。结论：在严重脑损伤所致的气管切开伴吞咽障碍的意识障碍患者中，与吞咽功能恢复较好相关的因素包括初始MEBDT结果、1年内拔除气切套管和1年时的GCS评分。 |
| 英文摘要: |
| Objective: To explore the factors influencing swallowing outcome in patients with disorders of consciousness patients with tracheostomy. Methods: This retrospective study collected clinical data of disorder of consciousness patients with tracheostomy. The data included demographic characteristics at admission, CRS-R scores, GCS scores, modified Evans blue dye test, duration of tracheostomy and Functional Oral Intake Scale (FOIS) at admission. Follow-up was conducted at 1 year to collect tracheostomy decannulation status, GCS scores and FOIS scores. A total of 141 patients with disorder of consciousness were included in this study and the data of 138 participants were included in the final analysis. Based on the FOIS scores at one year of follow-up, the patients were divided into two groups: poor swallowing function group (FOIS levels 1-3) with 71 cases and good swallowing function group (FOIS levels 4-7) with 70 cases. Logistic regression analysis was employed to the correlation between various factors and the recovery of swallowing function. Results: The decannulation rate was higher in the good swallowing function group than in the poor swallowing function group (P<0.01), and the proportion of patients with a GCS score ≥8 was higher in the good swallowing function group than the poor swallowing function group (P<0.05). Logistic regression analysis revealed that dye test results, tracheostomy decannulation within 1 year, and GCS scores at 1 year significantly influenced the recovery of swallowing function recovery at 1 year (P<0.05, 0.01). Conclusion: Factors associated with better swallowing function recovery in disorder of consciousness patients with tracheostomy due to severe brain injury include initial modified dye test results, decannulation within 1 year, and GCS scores at 1 year. |
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