作者：刘必琴，顾志娥，施杨，陈应柱，胡娅莉

单位：

1.扬州大学护理学院·公共卫生学院2.江苏省扬州五台山医院护理部3.江苏省苏北人民医院老年科4.江苏省苏北人民医院神经内科

Units：

1.School of Nursing·School of Public Health, Yangzhou University, Yangzhou 225000, China 2.Department of Nursing, Jiangsu Province Wutaishan Hospital of Yangzhou, Yangzhou 225000, China 3.Department of Geriatrics, Northern Jiangsu People's Hospital, Yangzhou 225000, China 4.Department of Neurology, Northern Jiangsu People's Hospital, Yangzhou 225000, China

关键词：

卒中; 卒中相关性肺炎; Gugging吞咽功能评估量表; 预测;

Keywords：

Stroke; Stroke-associated pneumonia; Gugging Swallowing Screen; Forecast

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.139

Funds：

江苏省人兽共患病学重点实验室“护馨基金”2021年度开放课题（HX2104）；江苏省苏北人民医院管理课题 （YYGL202205）

摘要：

目的 探讨Gugging吞咽功能评估量表（GUSS）评分对卒中患者发生卒中相关性肺炎（SAP）的预测价值。方法 选取2020年6月至2022年6月江苏省苏北人民医院收治的卒中患者192例，以是否发生SAP将其分为SAP组（n=32）和非SAP组（n=160）。收集所有患者的一般资料、GUSS评分、洼田饮水试验分级。采用多因素Logistic回归分析探讨卒中患者发生SAP的影响因素。绘制决策曲线以探讨GUSS评分对卒中患者发生SAP的预测价值。结果 SAP组年龄大于非SAP组，美国国立卫生研究院卒中量表（NIHSS）评分、洼田饮水试验分级≥3级者占比高于非SAP组，GUSS评分低于非SAP组（P<0.05）。多因素Logistic回归分析结果显示，年龄增长、NIHSS评分升高、洼田饮水试验分级≥3级是卒中患者发生SAP的危险因素，GUSS评分升高是卒中患者发生SAP的保护因素（P<0.05）。决策曲线分析结果显示，当高风险阈值为0～0.38时，GUSS评分预测卒中患者发生SAP的净获益率>0，当高风险阈值为0.16～0.34时，GUSS评分预测卒中患者发生SAP的净获益率高于洼田饮水试验分级≥3级。结论 GUSS评分用于预测卒中患者发生SAP具有一定净获益。

Abstract：

Objective To investigate the predictive value of Gugging Swallowing Screen (GUSS) score for strokeassociated pneumonia (SAP) in stroke patients. Methods A total of 192 stroke patients admitted to Northern Jiangsu People's Hospital from June 2020 to June 2022 were selected and divided into SAP group (n=32) and non-SAP group (n=160) according to whether SAP occurred. General data, GUSS score and water swallow test grade of all patients were collected. Multivariate Logistic regression analysis was used to investigate influencing factors of SAP in stroke patients. The predictive value of GUSS score for SAP in stroke patients was studied by drawing decision curve. Results Age of SAP group was older than that of nonSAP group, and National Institute of Health stroke scale (NIHSS) score, and the proportion of water swallow test grade ≥ 3 of SAP group were higher than those of non-SAP group, while GUSS score was lower than that of non-SAP group (P < 0.05) . The results of multivariate Logistic regression analysis showed that increased age, increased NIHSS score, and water swallow test grade ≥ 3 were risk factors for SAP in stroke patients, while increased GUSS score was a protective factor for SAP in stroke patients (P < 0.05) . The results of decision curve analysis showed that when the high risk threshold was 0-0.38, the net benefit rate of SAP in stroke patients predicted by GUSS score was > 0; when the high risk threshold was 0.16-0.34, the net benefit rate of SAP in stroke patients predicted by GUSS score was higher than that of water swallow test grade ≥ 3. Conclusion GUSS score has a net benefit in predicting SAP in stroke patients.

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