脑卒中后阻塞性睡眠呼吸暂停患者口咽部形态学变化及其与功能恢复的相关性

发布时间：2018-03-05 09:08

本文选题：脑卒中　切入点：阻塞性睡眠呼吸暂停　出处：《中国康复医学杂志》2015年12期 　论文类型：期刊论文

【摘要】：目的:分析卒中后阻塞性睡眠呼吸暂停(OSA)患者口咽部形态学变化及其与功能恢复之间的相关性,为寻求脑卒中并发OSA的康复治疗措施提供依据。方法:选取首次发病且病程1个月之内的脑卒中患者39例,排除发病前已确诊OSA的患者,入组患者均行多导睡眠图(PSG)监测、口咽部核MRI检查及各项功能评估,将并发与不并发OSA患者的咽部MRI测量相关指标进行比较,将脑卒中并发OSA患者的咽部测量指标与患者的功能评估指标进行相关分析。结果:1并发OSA的脑卒中患者腭后距离、舌后距离较不并发OSA者偏小、软腭长度较不并发OSA者偏大,两者相比有显著性差异(P=0.002/0.003/0.019)。2脑卒中并发OSA患者的腭后距离与改良Barthel指数评分呈正相关、与改良Rankin分级呈负相关;舌后距离与患者的NIHSS评分、改良Rankin分级呈负相关,与患者Fugl-Meyer评分、改良Barthel指数评分呈正相关(P0.05)。结论:脑卒中并发OSA患者的口咽部形态学变化(腭后距离及舌后距离偏小)与患者的功能评估间有一定相关性,所以改善脑卒中后OSA患者口咽部形态学的变化有利于患者的功能恢复。
[Abstract]:Objective: to analyze the relationship between the changes of oropharynx morphology and functional recovery in patients with obstructive sleep apnea (OSA) after stroke. Methods: 39 stroke patients with the first onset and the course of disease within one month were selected to exclude the patients who had been diagnosed with OSA before onset, and all the patients in the group were monitored with polysomnography (PSG). The relative indexes of pharynx MRI measurement in patients with concurrent and non-complicated OSA were compared by MRI examination and functional evaluation of the oral and pharyngeal nucleus. Results the posterior palatal distance, retrolingual distance and soft palate length of stroke patients with OSA were smaller than those without OSA, and the length of soft palate was larger than that of patients without OSA. There was significant difference between the two groups. The posterior palatal distance of stroke patients with OSA was positively correlated with the modified Barthel index score, negatively correlated with the modified Rankin grade, and negatively correlated with the NIHSS score, the modified Rankin grade and the Fugl-Meyer score of the patients. The improved Barthel index score was positively correlated with P0.050.Conclusion: there is a certain correlation between the morphological changes of oropharynx (the posterior palatine distance and the retrolingual distance) and the functional evaluation of stroke patients with OSA. Therefore, improving the changes of oropharynx morphology in OSA patients after stroke is beneficial to functional recovery.
【作者单位】：南京医科大学第一附属医院康复医学科;南华大学附属第一医院;新疆库尔勒巴州人民医院康复医学科;
【基金】：江苏省兴卫工程重点学科经费资助项目
【分类号】：R743.3;R766

【参考文献】