Differences in the peak cough flow among stroke patients with and without dysphagia.
Differences in the peak cough flow among stroke patients with and without dysphagia.
复制标题
伴有和不伴有吞咽困难的中风患者咳嗽流量峰值的差异。
DOI：
10.7888/juoeh.35.9
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
K. Hachisuka
中科院分区：
文献类型：
--
作者：
Yoshiko Kimura;Masanori Takahashi;F. Wada;K. Hachisuka
咳嗽是保持呼吸道通畅的重要保护机制，充分的自主咳嗽可降低吞咽障碍患者的误吸风险。本研究采用肺量计对10例脑卒中吞咽困难（SPD）患者的最大咳嗽流量（PCF）进行了测定和比较，并对PCF的生理和呼吸因素进行了分析。20例无吞咽困难的脑卒中患者（SP）和10例性别和年龄匹配的健康对照（HC）通过在诊所和报纸上的通知招募。SPD的PCF（平均值± SD，160.1 ± 68.7 l/min）显著低于SP和HC的PCF（分别为297.2 ± 114.2 l/min和462.0 ± 84.4 l/min;单因素方差分析，Scheffe检验，P < 0.05）。SPD的肺活量（VC）和吸气储备容量（IRV）低于HC。多元逐步回归分析显示，IRV和Ambassador功能（Functional Ambassador Categories，FAC）对PCF的方差贡献率分别为50%和17%（P < 0.05）。提示呼吸功能，尤其是呼吸道通气功能，对维持SPD时PCF的稳定至关重要。
Coughing is an important protective mechanism for keeping the airway clear, and adequate voluntary coughing reduces the risk of aspiration in patients with deglutition disorders. The purpose of this study was to compare the peak cough flow (PCF) of stroke patients with and without dysphagia and to identify the physical and respiratory determinants of PCF.Using a spirometer, we measured and compared the PCFs of 10 stroke patients with dysphagia (SPD), 20 stroke patients without dysphagia (SP) and 10 gender and age matched healthy controls (HC) recruited by using a notice at a clinic and in newspapers. The PCF of the SPD (mean ± SD, 160.1 ± 68.7 l/min) was significantly lower than that of the SP and HC (297.2 ± 114.2 l/min and 462.0 ± 84.4 l/min, respectively; one-way ANOVA, Scheffe's test, P < 0.05). The vital capacity (VC) and inspiratory reserve volume (IRV) of the SPD were lower than those of the HC. Stepwise multivariate regression analysis revealed that IRV and ambulation function (Functional Ambulation Categories, FAC) contributed 50% and 17% to the variance of PCF (P < 0.05), respectively. It is suggested that respiratory function, especially IRV, is important for maintaining PCF in SPD.