CAJ | 학술논문

目的：探讨影响脑卒中后吞咽障碍康复的因素。方法回顾性分析脑卒中后吞咽障碍患者。将患者分为假性球麻痹组(n=296)和真性球麻痹组(n=82)。吞咽功能结局采用电视透视吞咽检查(VFSS)确定。采用Logistic回归分析发病年龄，性别，入院时体质量指数(BMI)、美国国立卫生研究院卒中量表(NIHSS)评分、简式Fug-Meyer运动评分(FMA)、改良Barthel指数(MBI)，住院期间有无气管插管、有无误吸，住院时间，吞咽功能训练开始时间对吞咽功能结局的影响。结果发病年龄、NIHSS评分、有无气管插管、误吸、吞咽功能训练开始时间是两组患者吞咽功能不良的危险因素，MBI是假性球麻痹患者吞咽功能的保护因素。结论发病年龄越小、病情越轻、无气管插管、无误吸、吞咽功能训练开始时间越早，越有利于吞咽功能的恢复，MBI评分越高越有利于假性球麻痹患者的吞咽功能恢复。
목적：탐토영향뇌졸중후탄인장애강복적인소。방법회고성분석뇌졸중후탄인장애환자。장환자분위가성구마비조(n=296)화진성구마비조(n=82)。탄인공능결국채용전시투시탄인검사(VFSS)학정。채용Logistic회귀분석발병년령，성별，입원시체질량지수(BMI)、미국국립위생연구원졸중량표(NIHSS)평분、간식Fug-Meyer운동평분(FMA)、개량Barthel지수(MBI)，주원기간유무기관삽관、유무오흡，주원시간，탄인공능훈련개시시간대탄인공능결국적영향。결과발병년령、NIHSS평분、유무기관삽관、오흡、탄인공능훈련개시시간시량조환자탄인공능불량적위험인소，MBI시가성구마비환자탄인공능적보호인소。결론발병년령월소、병정월경、무기관삽관、무오흡、탄인공능훈련개시시간월조，월유리우탄인공능적회복，MBI평분월고월유리우가성구마비환자적탄인공능회복。
Objective To investigate the factors related with swallowing function after stroke. Methods Stroke patients with dysphagia were reviewed, 296 cases with pseudobulbar paralysis, and 82 cases with bulbar paralysis. Swallowing function was evaluated with videoflu-oroscopic swallowing study (VFSS). The variable of age, sex, Body Mass Index (BMI), scores of National Institutes of Health Stroke Scale (NIHSS), Simplified Fug-Meyer Assessment (FMA) and modified Barthel Index (MBI), intubation, aspiration, length of hospitalization (LOH), and initiation of rehabilitation intervention were analyzed with Logistic regression. Results Age, NIHSS score, intubation, aspira-tion, initiation of rehabilitation intervention were the risk factors for poor outcome of swallowing function in all the patients, while the score of MBI was the protective factor for the pseudobulbar paralysis ones. Conclusion The younger the patients, the less the NIHSS score, no in-tubation, no aspiration, and the earlier the rehabilitation intervened, the more independent the pseudobulbar paralysis patients, the better swallowing function recovered.