CAJ | 학술논문

目的探讨老年脑梗死隐性误吸与卒中相关性肺炎(SAP)的相互关系,为SAP的风险评估与早期干预提供参考指标.方法对2011年10月至2013年4月在我院神经内科住院的60岁以上急性脑梗死患者100例,在人院后7d内完成吞咽电视荧光透视检查(VFSS),通过VFSS确定患者有无隐性误吸及其发生率,对隐性与显性误吸患者发生SAP的情况进行比较,分析隐性误吸与SAP的关系.结果完成VFSS的100例老年患者中,发生误吸46例,其中显性误吸19例,隐性误吸27例,隐性误吸占误吸病例的58.7％; 27例隐性误吸患者的平均年龄为(73.2±5.1)岁,19例显性误吸患者平均为(64.1±4.6)岁,发生隐性误吸的患者年龄高于显性患者;隐性误吸患者74.1％有SAP,而显性误吸患者36.8％有SAP,差异均具有统计学意义(P＜0.05).结论脑梗死隐性误吸随年龄增长而增加;隐性误吸比显性误吸更易发生SAP,可能是老年脑梗死SAP的独立危险因素.建议对老年脑梗死早期进行VFSS,及时发现隐性误吸.
목적 탐토노년뇌경사은성오흡여졸중상관성폐염(SAP)적상호관계,위SAP적풍험평고여조기간예제공삼고지표.방법 대2011년10월지2013년4월재아원신경내과주원적60세이상급성뇌경사환자100례,재인원후7d내완성탄인전시형광투시검사(VFSS),통과VFSS학정환자유무은성오흡급기발생솔,대은성여현성오흡환자발생SAP적정황진행비교,분석은성오흡여SAP적관계.결과 완성VFSS적100례노년환자중,발생오흡46례,기중현성오흡19례,은성오흡27례,은성오흡점오흡병례적58.7％; 27례은성오흡환자적평균년령위(73.2±5.1)세,19례현성오흡환자평균위(64.1±4.6)세,발생은성오흡적환자년령고우현성환자;은성오흡환자74.1％유SAP,이현성오흡환자36.8％유SAP,차이균구유통계학의의(P＜0.05).결론 뇌경사은성오흡수년령증장이증가;은성오흡비현성오흡경역발생SAP,가능시노년뇌경사SAP적독립위험인소.건의대노년뇌경사조기진행VFSS,급시발현은성오흡.
Objective To explore the relationship between the silent aspiration in elderly cerebral infarction and stroke associated pneumonia (SAP) and provide some references for the risk assessment and early intervention of SAP.Methods 100 patients over 60 years old and with acute cerebral infarction were selected from the department of neurology of our hospital from August,2011 to April,2013.Videofluoroscopic swallowing study(VFSS) was completed within 7 days after being hospitalized by all the patients.Silent aspiration and its incidence of the patients were determined by VFSS.The differences of SAP between silent aspiration and overt aspiration were compared.The relationship between silent aspiration and SAP was analyzed.Results Among the 100 elderly patients completing VFSS,46 cases occurred aspiration (19 cases were overt aspiration and 27 cases were silent aspiration).The silent aspiration accounted for 58.7％ of the aspiration.The average age of the 27 patients occurring silent aspiration was (73.2 ± 5.1) years,and that of the 19 patients occurring overt aspiration were(64.1 ± 4.6) years old.The patients occurring silent aspiration were older than the patients occurring overt aspiration.The incidence of SAP was higher in the patients occurring silent aspiration than in the patients occurring overt aspiration,with statistical differences (P＜0.05).Conclusions The aspiration rate of acute cerebral infarction increases with age.SAP is more likely to happen in the patients occurring silent aspiration than in the patients occurring overt aspiration.Silent aspiration may be the independent risk factor of SAP in elderly patients with cerebral infarction.VFSS is the most objective evaluation method for silent aspiration.VFSS should be taken by the elderly patients with cerebral infarction of early stage to detect silent aspiration in time.