中村記念南病院における脳血管障碍に伴う摂食・嚥下障碍症例の検討
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概要
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Twenty seven cases suffering from cerebrovascular disorders with associated dysphagia were admitted at Nakamura Memorial South Hospital for various periods of time between October 2003 to June 2005. Fifteen cases were male, and 12 were female, with ages ranging from 36-89 years of age (mean 73.0 ± 10.9). Nineteen cases had cerebral infarctions, and the remaining 8 had intracerebral hemorrhages. The patients underwent a series of rehabilitatory exercises aimed at improving their swallowing. Initially, prior to the commencement of the exercise, some 71.4% were unable to ingest anything from their mouths. Moreover, 48.1% of the patients had indications that they would only be suitable for indirect swallowing exercises. However, after undergoing the prescribed exercise course for an average of 68.5 days, 74.1% of the patients were able to feed directly from their mouths, and 63.0% of the patients were freed from their feeding tubes or intravenous hyperalimentation. Various prognostic factors for dysphagia were considered in this clinical study. Aspects that did not appear to be significant prognostic factors included the period of time between the initial onset and the beginning of swallowing exercise, type of cerebrovascular disorder (infarction or hemorrhage), number of foci, existence of unilateral or bilateral lesions, status of attack (first attack or reattack), or upper limb function. Conversely, age, performance status, mental function, and swallowing acuity at the beginning of the exercise, all correlated significantly with final swallowing acuity, indicating that these variables could reasonably be considered likely prognostic factors.
- 2008-03-01
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