Characteristics Of Swallowing Disorders In Brainstem Stroke And Analysis Of Related Influencing Factors

Objective:The video fluoroscopic study of swallowing(VFSS)was used to investigate the characteristics and related factors of dysphagia in patients with brain stem stroke,and to provide a theoretical basis for individualized rehabilitation and treatment.Methods:A total of 149 stroke patients diagnosed by head MRI or CT between August 2012 and September 2018 in the First Hospital of Shanxi Medical University were selected for VFSS before rehabilitation.The doctors of the rehabilitation department used the iodine-containing contrast agent to prepare liquids,thickeners and thickeners for the patients.Give the patient a liquid of 10 ml,15ml respectively,and then give the patient the same amount of thick and thick matter under the condition of permission.The patient will swallow the oral group and use the VFSS technique to record the patient's swallowing process.The opening of the pharyngeal muscle,the degree of laryngeal elevation,the residual piriform fossa,whether the patient coughs after aspiration,and the appearance of the pharyngeal muscle notch.In addition,118 patients with radiological gastrointestinal angiography were randomly selected from our hospital for physical examination and other reasons,except for other reasons,as a healthy control group,10 ml,15 ml contrast agent was given,and the swallowing process was recorded in video form.According to the stroke site,it was divided into brainstem group and non-brain stem group;the opening of the pharyngeal muscle was judged by the opening of the ringmuscle of the healthy control group.Rosenbek penetration/sucking scale to determine whether it is aspiration,whether it is caused by dominant aspiration and occult aspiration within 1 minute after aspiration.The incidence of abnormal dysphagia patterns in the brainstem group and non-brain stem group was measured by chi-square test;the open width of different doses of pharyngeal muscle in healthy control group was tested by independent sample t test,and LOGISTI regression analysis caused aspiration of stroke patients.Risk factors.All data were analyzed by SPSS22.0 statistical software.P<0.05 was used to determine the difference.Results:1.VFSS results of patients with brain stem stroke showed: 23 cases(74.2%)with open circulatory pharyngeal muscle,12 cases(38.7%)with laryngeal elevation,24 cases(77.4%)with piriform sac,and dominant aspiration 4.For example(12.9%),22 cases(71.0%)were occult aspiration and 5 cases(16.1%)were infiltrated.2.Comparison of results between brainstem group and non-brain stem group:abnormal opening of the pharyngeal muscle(x2=97.924,p<0.05),insufficient laryngeal elevation(x2=4.033,p=0.05),piriform fossa residual(x2= 38.621,p<0.05),dominant aspiration(x2=1.322,p=0.25),occult aspiration(x2=27.162,p<0.05).3.In the healthy control group,the open width of the pharyngeal muscle was 10 ml and 15 ml respectively....There were 15 cases of cycloparyngeal muscle incision in 4.118 patients with dysphagia,and 6 cases of cycloparyngeal muscle incision in 118 patients with normal swallowing function.5.The LOGISTIC regression analysis between the abnormal laryngeal elevation and aspiration was statistically significant within the 95% confidence interval with an OR of15.870.Conclusion:1.The manifestations of dysphagia in brain stem stroke are: open circulatory pharyngeal muscle,insufficient laryngeal elevation,residual piriform fossa,and aspiration.2.Patients with brain stem stroke are mainly circumflex pharyngeal muscle open disorder and occult aspiration.3.The amount of food affects the open width of the pharyngeal muscle,increases the amount of food,and increases the open width of the pharyngeal muscle.4.Patients with dysphagia have a higher rate of pharyngeal muscle incision than those without dysphagia.5.Open abnormalities of the pharyngeal muscle are risk factors for stroke patients with stroke,and abnormal laryngeal elevation is a risk factor for aspiration in stroke patients.