摘要
Abstract
Objective To investigate the correlation between clinical presentations and the findings of video fluoroscopic swallowing study (VFSS)in patients with post-stroke dysphagia. Methods A total of 56 consecutive patients with post-stroke dysphagia admitted to Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from June 2012 to May 2014 were enrolled. Four different kinds of food were selectively used to complete clinical assessment of swallowing function and VFSS respectively. The SPSS 20. 0 statistical software was used to perform univariate and multivariate Logistic regression analyses for all observed indexes of the 2 methods. Results there were significant correlations in the point correspondence relation among the clinical manifestations and VFSS in food residue in the mouth and abnormal closure of lips in the oral phase (95%CI 1. 430-101. 468;P=0. 022);poor soft palate elevation and food residue in the mouth (95%CI 1. 476-102. 033;P=0. 020);graded swallowing and piecemeal deglutition with delayed oral transit (95% CI 2. 616 -182. 897;P = 0. 004);tongue movement disorders,poor soft palate elevation and tongue dyskinesia with poor bolus formation (95%CI 1. 468-50. 795,1. 220-13. 825;P=0. 017,0. 023);food leak from the corner of mouth,dysphagia,bolus falling to the epiglottis from the base of tongue or trachea (95%CI 1. 146-125. 459,1. 657-174. 400;P=0.038,0. 017). The weakened pharyngeal reflex with weak laryngeal elevation in the pharyngeal phase (95%CI 1. 150-92. 815;P =0. 037);dysphagia and delayed swallowing with prolonged triggering of swallowing reflex (95%CI 2. 123-37. 770,1. 233-114. 176;P=0. 003,0. 032);graded swallowing,hard swallowing, choking sensation,and poor laryngeal elevation with prolonged pharyngeal transit (95%CI 1. 619-223. 316,1. 061-31. 445,2. 834 -132. 707;P =0. 019,0. 042,and 0. 003);dysphagia and the opening of cricopharyngeal muscle insufficiency (95%CI 1. 037 -24. 115;P =0. 045);weak laryngeal elevation,foreign body sensation in the throat,and choking after swallowing with food retention or residual in vallecula or pyriform sinus (95%CI 1. 046 -13. 685,1. 116 -87. 741;P =0. 043, 0.040);and coughing during swallowing and eating choking or aspiration (95%CI 0. 010-0. 921,0. 037-0. 826;P=0. 042,0. 028). Conclusion Some clinical manifestations are closely correlated with the swallowing dysfunction revealed by VFSS. With the help of this law,it may more simply and safely determine the degree and type of dysphagia in patients,and provide guidance for patients with dysphagia after stroke who can not accept VFSS in the rehabilitation treatment.关键词
卒中/吞咽困难/Logistic回归分析/荧光透视检查Key words
Stroke/Dysphagia/Logistic regression analysis/Video fluoroscopic swallowing study
