Đặc điểm rối loạn nuốt và một số yếu tố liên quan ở người bệnh đột quỵ cấp=Characteristics of dysphagia and some related factors in acute stroke patients

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Tác giả: Thị Thu Hiền Nguyễn, Hữu Thông Trần, Hữu Trung Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.397-404

Bộ sưu tập: Metadata

ID: 477918

Thêm vào giỏ

Determine the rate of dysphagia and some related factors in acute stroke patients. Subjects and methods: Includes 951 patients with acute stroke, screened for dysphagia using the GUSS scale at the Neurology Center, Bach Mai Hospital from December 2020 to December 2022. Factors associated with dysphagia were analyzed by univariate and multivariate logistic regression. Results: 64.4% of subjects were males, the mean age was 65.3. The rate of dysphagia among acute stroke patients was 71.6%. Of these, mild, moderate, and severe dysphagia account for 37.4%, 11.4%, and 22.8%, respectively. The rate of feeding through a nasogastric tube was 30.8% of patients. Inability to cough spontaneously and/or to clear the mouth actively was the most common symptom. Dysphagia was statistically significantly associated with age groups 50–59 (OR = 2.2, 95% CI: 1.2–4.2), age group 60–69 (OR = 1.9
95% CI: 1.04–3.4), age group >
70 (OR = 5.4
95% CI: 2.8 – 10.3), brainstem stroke (OR = 4.0
95% CI: 2, 1–7.4), communication disorders (OR = 1.5
95% CI: 1.1–7.4) and facial paralysis (OR = 17.9
95% CI: 12.0–26, 8). Conclusion: Dysphagia was statistically significantly associated with age groups, brainstem stroke, communication disorders and facial paralysis among acute stroke patients. Management strategies after acute stroke should pay more attention to these issues.Xác định tỉ lệ, đặc điểm rối loạn nuốt và một số yếu tố liên quan ở người bệnh đột quỵ cấp. Đối tượng và phương pháp: Gồm 951 người bệnh đột quỵ cấp, được sàng lọc rối loạn nuốt bằng thang điểm GUSS tại Trung tâm Thần kinh, Bệnh viện Bạch Mai từ tháng 12/2020 đến tháng 12/2022. Các yếu tố liên quan đến rối loạn nuốt được phân tích đơn biến và hồi quy logistic đa biến. Kết quả: Tuổi trung bình của người bệnh là 65,3, nam giới chiếm đa số 64,4%, tỉ lệ rối loạn nuốt sau nhồi máu não cấp được ghi nhận là 71,6%. Trong đó, rối loạn nuốt nhẹ, trung bình và nặng chiếm tỉ lệ lần lượt là 37,4%, 11,4% và 22,8%. Có 30,8% người bệnh cần nuôi dưỡng qua ống thông dạ dày. Không thể ho và/hoặc không thể làm sạch khoang miệng chủ động là triệu chứng chiếm tỉ lệ cao nhất. Rối loạn nuốt liên quan có ý nghĩa thống kê với nhóm tuổi 50– 59 (OR = 2,2, 95% CI: 1,2–4,2), nhóm tuổi 60– 69 (OR = 1,9
95% CI: 1,04–3,4), nhóm tuổi >
70 (OR = 5,4
95% CI: 2,8 – 10,3), tổn thương tại thân não (OR = 4,0
95% CI: 2,1–7,4), rối loạn giao tiếp (OR = 1,5
95% CI: 1,1–7,4) và liệt mặt (OR = 17,9
95% CI: 12,0–26,8). Kết luận: Rối loạn nuốt có liên quan đến các nhóm tuổi, tổn thương tại thân não, rối loạn giao tiếp và liệt mặt ở người bệnh đột quỵ não cấp tính. Chiến lược quản lý sau đột quỵ cấp tính cần chú trọng hơn đến những nội dung này.

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