| Objective:To Analyze the correlation between different manifestations of patients with acute ischemic stroke and the brain injury sites,laterality,cognitive impairment,dysarthria,and other factors.It is helpful to Clinicians conduct early risk assessments of patients,and provide more precise recommendations for the selection of post-stroke dysphagia rehabilitation treatment.It can also optimize the management of AIS patients,reduce complications,and improve their quality of life.Method:This study is a retrospective study based on medical records,approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University,the study was conducted on AIS patients treated in the Department of Rehabilitation Medicine of our hospital from January 2018 to November 2020.A total of 105 cases were included.The basic data such as gender,age,body mass index(BMI),history of smoking and drinking,and history of hypertension was collected through electronic medical record data.The clinical evaluation and Videofluoroscopic swallowing study(VFSS)were used to obtain swallowing Related parameters,such as poor oromotor control,tongue dyskinesia,incomplete oral closure,residual epiglottis,invalid upper esophageal sphincter(UES)opening,insuffcient laryngeal lift,and infiltration aspiration.The magnetic resonance imaging technology(MRI)was used to determine the location of AIS injury,and then established a multi-factor Logistic regression model to explore the correlation between factors.Result:This study found that:(1)The risk of tongue dyskinesia symptoms in patients with pontine injury increased by 5.14 times;(2)The risk of invalid upper esophageal sphincter opening in patients with Medulla oblongata injury increased by 4.43 times;(3)In patients with dysarthria,the risk of tongue dyskinesia increased by 18.12 times,the risk of poor oromotor control increased by 19.70 times,and the risk of incomplete oral closure increased by 11.96 times;(4)Patients with cognitive impairment had 6.27 times increased risk of symptoms of poor oromotor control;(5)Basal ganglia injury is an independent influencing factor of epiglottis residual;(6)Medulla oblongata injury is an independent influencing factor of tongue dyskinesia,difficulty in opening the mouth,and incomplete oral closure;Conclusion:For patients with dysphagia due to acute ischemic stroke,pontine injury and dysarthria are independent risk factors for tongue dyskinesia;dysarthria and cognitive impairment are independent risk factors for difficulty in opening the mouth;dysarthria is an independent risk factors for incomplete oral closure;Medulla oblongata injury is an independent risk factor for upper esophageal sphincter dysfunction. |
