上海某社区新发脑卒中后吞咽障碍患者现况调查*(1)
摘 要 目的：了解普陀区甘泉社区新发脑卒中合并吞咽障碍患者回归社区后的生存现况及康复需求，为今后社区康复治疗积累资料。方法：收集2012年1月-2013年3月回归社区的新发脑卒中后吞咽障碍患者69例，采用自制调查表对患者现况进行分析，包括吞咽障碍程度、对社区康复需求、日常生活能力评估等。结果：69例患者中4.3%曾接受综合性医院与吞咽障碍相关的康复治疗或出院康复指导，30.4%患者曾在住院期间发生吸入性肺炎，100%患者希望得到社区吞咽障碍康复指导，洼田评分3级者28例(49.1%)， MBI评分轻度功能缺陷者31例(44.9%)。结论：社区新发脑卒中后吞咽障碍患者以轻、中度吞咽障碍和生活能力缺陷为主，对康复需求迫切，亟待重视及解决。
关键词 吞咽障碍 脑卒中 康复
中图分类号：R743.3 文献标识码：B 文章编号：1006-1533(2015)10-0023-03
Prevalence survey of the patients with dysphagia after new stroke
, http://www.100md.com
in a community in Shanghai
WANG Lixia1， Geng Ying1， GU Yiqun1， LIN Lin1， WANG Le2
(1.Ganquan Community Health Service Center of Putuo District， Shanghai 200065， China； 2.Dachang Community Health Service Center of Baoshan District， Shanghai 200442， China)
ABSTRACT Objective： To understand the survival status and the rehabilitation requirement of the new stroke patients merged with dysphagia after they returned to the community to accumulate the data for the community rehabilitation and treatment in the future. Methods： Sixty-nine new stroke patients with dysphagia after they returned to the community were collected from Jan. 2012 to March 2013. The self-made questionnaire was used to analyze the patients’ current status， which included the swallowing disorders degree， community rehabilitation need， and daily living ability assessment and so on. Results： 4.3% of 69 patients had once received the rehabilitation treatment and dysphagia related rehabilitation and treatment in the general hospital or out-hospital guidance， 30.4% of them had the occurrence of aspiration pneumonia during the hospitalization， and 100% of them hoped to get the community dysphagia rehabilitation guidance. The Kubota score 3 was 28 cases (49.1%) and MBI score of the mild dysfunction 31 cases (44.9%). Conclusion： The mild and moderate dysphagia and living ability defects are primarily in the new stroke patients with dysphagia after they return to the community and the rehabilitation requirement is urgent， to which attention needs to be paid and solved.
, 百拇医药
KEY WORDS dysphagia； stroke； rehabilitation
吞咽障碍是脑卒中后常见而严重的合并症，可独立影响病死率[1]，吞咽障碍与肺部感染有关，并有引起化学性肺炎和气道阻塞的危险，也与脱水和营养不良有关，可导致康复时间延长、并发症发生率增高、再入院率和病死率增高[2]。据文献分析，在美国，许多吞咽障碍患者因未能得到及时诊断和治疗而导致吸入性肺炎，用于吸入性肺炎的医疗费用(在20世纪90年代每例平均5 800美元)远超过医疗保险规定的支付限度[3-6]。为此，美国医学界1992年成立了多学科参加的国家级学术组织、吞咽障碍研究协会和专科诊疗中心，还在全国范围内建立了许多附属于各地保健所的吞咽中心，承担居民吞咽障碍的诊治工作。而我国医学界对吞咽障碍问题的关注远不及国外，尤其对于新发脑卒中后吞咽障碍患者回归社区家庭后的研究更少，在2010年前几乎少有来自社区的相关研究文献报道 [7-9]。为了解本社区新发脑卒中患者从综合性或专科医院出院回归社区后吞咽障碍的发生情况、患者的生存现状及康复需求，普陀区甘泉社区进行了本次调查，现报道如下。, 百拇医药(王黎霞等)
关键词 吞咽障碍 脑卒中 康复
中图分类号：R743.3 文献标识码：B 文章编号：1006-1533(2015)10-0023-03
Prevalence survey of the patients with dysphagia after new stroke
, http://www.100md.com
in a community in Shanghai
WANG Lixia1， Geng Ying1， GU Yiqun1， LIN Lin1， WANG Le2
(1.Ganquan Community Health Service Center of Putuo District， Shanghai 200065， China； 2.Dachang Community Health Service Center of Baoshan District， Shanghai 200442， China)
ABSTRACT Objective： To understand the survival status and the rehabilitation requirement of the new stroke patients merged with dysphagia after they returned to the community to accumulate the data for the community rehabilitation and treatment in the future. Methods： Sixty-nine new stroke patients with dysphagia after they returned to the community were collected from Jan. 2012 to March 2013. The self-made questionnaire was used to analyze the patients’ current status， which included the swallowing disorders degree， community rehabilitation need， and daily living ability assessment and so on. Results： 4.3% of 69 patients had once received the rehabilitation treatment and dysphagia related rehabilitation and treatment in the general hospital or out-hospital guidance， 30.4% of them had the occurrence of aspiration pneumonia during the hospitalization， and 100% of them hoped to get the community dysphagia rehabilitation guidance. The Kubota score 3 was 28 cases (49.1%) and MBI score of the mild dysfunction 31 cases (44.9%). Conclusion： The mild and moderate dysphagia and living ability defects are primarily in the new stroke patients with dysphagia after they return to the community and the rehabilitation requirement is urgent， to which attention needs to be paid and solved.
, 百拇医药
KEY WORDS dysphagia； stroke； rehabilitation
吞咽障碍是脑卒中后常见而严重的合并症，可独立影响病死率[1]，吞咽障碍与肺部感染有关，并有引起化学性肺炎和气道阻塞的危险，也与脱水和营养不良有关，可导致康复时间延长、并发症发生率增高、再入院率和病死率增高[2]。据文献分析，在美国，许多吞咽障碍患者因未能得到及时诊断和治疗而导致吸入性肺炎，用于吸入性肺炎的医疗费用(在20世纪90年代每例平均5 800美元)远超过医疗保险规定的支付限度[3-6]。为此，美国医学界1992年成立了多学科参加的国家级学术组织、吞咽障碍研究协会和专科诊疗中心，还在全国范围内建立了许多附属于各地保健所的吞咽中心，承担居民吞咽障碍的诊治工作。而我国医学界对吞咽障碍问题的关注远不及国外，尤其对于新发脑卒中后吞咽障碍患者回归社区家庭后的研究更少，在2010年前几乎少有来自社区的相关研究文献报道 [7-9]。为了解本社区新发脑卒中患者从综合性或专科医院出院回归社区后吞咽障碍的发生情况、患者的生存现状及康复需求，普陀区甘泉社区进行了本次调查，现报道如下。, 百拇医药(王黎霞等)