Oxygen desaturation on swallowing as a potential marker of aspiration in acute stroke.
Oxygen desaturation on swallowing as a potential marker of aspiration in acute stroke.
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吞咽时的氧饱和度降低是急性中风误吸的潜在标志。
DOI：
10.1093/ageing/24.4.267
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发表时间：
1995
期刊：
影响因子：
6.7
通讯作者：
Martin J. Connolly
中科院分区：
文献类型：
--
作者：
N. H. Zaidi;H. A. Smith;S. C. King;C. Park;Paul A O'Neill;Martin J. Connolly
我们评估了血氧饱和度(SaO2)测量作为检测中风患者误吸的一种手段。在10周的时间里，所有的急性中风入院患者都在48小时内。采用脉搏血氧饱和度测定仪测定基础SaO2。患者在坐起时吞下10ml水，并记录SaO2达2分钟。两个对照组[年轻，健康(YF)和年龄和性别匹配的住院患者，非神经系统疾病(IP)]接受了同样的评估。受试者接受由言语和语言治疗师(SLT)进行的吞咽独立评估。排除标准包括意识障碍、其他神经系统疾病和胸部感染。研究对象49例，其中男性20例，年龄46~93岁(平均71岁)，青年55例[男性26例，年龄18~55岁(平均32岁)]，IP 65例[男性28例，年龄53~96岁(平均71岁)]。AS患者的平均(SD)SaO2下降[2.6(2.9)%]明显高于YF[1.1(0.8)%]或IP[1.1(0.9)%]。YF和IP之间SaO2变化的95%可信下限没有差异(3.0%‘下降’)；19例(39%)受试者降至低于95%的可信下限。SLT分级的“吸引者”平均SaO2下降[4.6(2.7)%]明显高于“非吸引者”[1.4(1.0)%]。我们得出的结论是：(1)急性卒中患者吞咽液体时血氧饱和度下降是常见的；(2)血氧饱和度降低的存在与否与SLT对吸入的评估在统计学上是一致的；(3)血氧饱和度的测量可能有助于床边对吞咽的评估。
We have assessed the measurement of oxygen saturation (SaO2) as a means of detecting aspiration in patients with stroke. For 10 weeks all acute stroke [AS] admissions were seen within 48 hours. Basal SaO2 was measured by pulse oximetry. Patients swallowed 10ml water while sitting up and SaO2 was noted for 2 minutes. Two control groups [young, fit (YF) and inpatient age- and sex-matched, non-neurological disease (IP)] underwent the same assessment. AS subjects underwent independent assessment of swallowing by a speech and language therapist (SLT). Exclusion criteria comprised impaired consciousness, other neurological disease and chest infection. Forty-nine AS subjects [20 men; aged 46-93 (mean 71) years], 55 YF [26 men; aged 18-55 (mean 32) years] and 65 IP [28 men; aged 53-96 (mean 71) years] were studied. Mean (SD) SaO2 fall in AS subjects [2.6 (2.9)%)] was significantly more than in YF [1.1 (0.8)%] or IP [1.1 (0.9)%]. The lower 95% confidence limit for variation in SaO2 did not differ between YF and IP (3.0% 'fall'); 19 (39%) AS subjects desaturated below this 95% lower confidence limit. Mean (SD) SaO2 fall was significantly more in SLT-graded 'aspirators' [4.6 (2.7)%] than 'nonaspirators' [1.4 (1.0)%]. We conclude that (1) a fall in SaO2 on swallowing fluid is common in patients with acute stroke; (2) the presence or absence of desaturation agrees statistically with SLT assessment of aspiration; (3) SaO2 measures may aid bedside assessment of swallowing.