与卒中后吞咽困难6个月经口进食恢复相关的肌肉、营养及视频透视因素
Muscle, Nutritional, and Videofluoroscopic Factors Associated With 6-Month Oral Intake Recovery in Post-Stroke Dysphagia.
文献信息
| PMID | 42968355 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Seongmin Choi |
| 作者单位 | Department of Physical and Rehabilitation Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea. |
| 期刊 | American journal of physical medicine & rehabilitation |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 确定肌肉、营养及视频透视因素是否与卒中后6个月经口进食恢复相关。
设计： 这项单中心回顾性队列研究纳入1,286名成人，患有缺血性或出血性卒中、口咽吞咽困难、基线功能性经口进食量表（FOIS）评分为1至4分，并在卒中发病180天内接受指标视频透视检查。主要分析仅限于6个月时存活的1,241名患者。成功经口进食恢复定义为在180±30天时达到可进食多种稠度食物的完全经口进食（FOIS≥5）；6个月前死亡另行分析。
结果： 在1,241名6个月存活者中，748名（60.3%）实现成功经口进食恢复。恢复 odds 较低与以下因素相关：低骨骼肌质量指数（校正比值比0.67；95%置信区间0.50-0.90）、低握力（0.69；0.51-0.92）、老年营养风险指数低于98（0.75；0.56-1.00）、穿透-误吸量表评分6分或更高（0.60；0.43-0.83）、中度或重度会厌谷残留（0.65；0.49-0.85）以及中度或重度梨状窦残留（0.57；0.42-0.77）。
结论： 在调整卒中严重程度、认知、失语、病灶特征及主要合并症后，视频透视吞咽检查结果与间接全身脆弱性标志物为卒中存活者6个月经口进食恢复提供了互补信息。
英文摘要
OBJECTIVE: To determine whether muscle, nutritional, and videofluoroscopic factors were associated with 6-month oral intake recovery after stroke.
DESIGN: This single-center retrospective cohort study included 1,286 adults with ischemic or hemorrhagic stroke, oropharyngeal dysphagia, baseline Functional Oral Intake Scale (FOIS) scores of 1 to 4, and index videofluoroscopy within 180 days of stroke onset. The primary analysis was restricted to the 1,241 patients alive at 6 months. Successful oral intake recovery was defined as achievement of total oral intake with multiple consistencies (FOIS ≥5) at 180±30 days; death before 6 months was analyzed separately.
RESULTS: Among 1,241 six-month survivors, 748 (60.3%) achieved successful oral intake recovery. Lower odds of recovery were associated with low skeletal muscle mass index (adjusted odds ratio, 0.67; 95% confidence interval, 0.50-0.90), low grip strength (0.69; 0.51-0.92), Geriatric Nutritional Risk Index less than 98 (0.75; 0.56-1.00), Penetration-Aspiration Scale score of 6 or higher (0.60; 0.43-0.83), moderate or severe vallecular residue (0.65; 0.49-0.85), and moderate or severe pyriform sinus residue (0.57; 0.42-0.77).
CONCLUSION: Videofluoroscopic swallowing findings and indirect systemic vulnerability markers provided complementary information regarding 6-month oral intake recovery among stroke survivors after adjustment for stroke severity, cognition, aphasia, lesion characteristics, and major comorbidities.