《国际功能、残疾和健康分类》应用于脑卒中后吞咽障碍的初步研究

摘要

Objective:To screen and identify international classification of functioning,disability and health( ICF)core sets for spasticity and make a dedicated and comprehensive assessment tool for dysphagia after stroke. In order to strengthen difficulty swallowing tube. Methods:Forty patients with dysphagia after stroke were involved in this study. Using trhreats,re-search refining the core category of the swallowing disorder to complete preliminary clinical evaluation. Information about them was collected by clinical investigation. The ICF scale was used to assess the severity of each item. Each item′s frequency was calculated and those items with frequencies≥30% were selected as the first ICF core sets for spasticity. Items with frequency≥50% were chosen as the second level ICF core sets for spasticity. The two results(termed ICF core sets Ⅰ and Ⅱ)were in-tegrated with the initial ICF core sets for spasticity. Items with a frequency≥80% were chosen as the final ICF core set for spasticity. Results:A total of 34 ICF items were included in the ICF core set for spasticity after stroke. There were 18 body function items,2 body structure items,7 activity and participation items and 7 environmental items involved. Conclusion:The ICF core set for spasticity was identified in this study. The selected items covered content broader than other common spasm as-sessment scales. The result is a comprehensive description of spasticity.%目的：探讨并筛选出吞咽障碍的国际功能、残疾和健康分类（ICF）核心项目，为吞咽障碍的评估提供全面整体的特异性测量工具，加强吞咽困难的管理。方法：选择脑卒中恢复期、后遗症期吞咽障碍的患者40例，采用Threats 提炼的吞咽障碍核心项目初步临床评估，将评估结果中被选频率≥30%的项目提取组成吞咽 ICF 核心项目Ⅰ，将被选频率≥50%的项目提取组成吞咽障碍 ICF 核心项目Ⅱ，再将 ICF 核心项目Ⅰ和Ⅱ整合成吞咽 ICF 核心项目，将被选频率≥80%的项目提取组成吞咽 ICF 核心项目最终完成版。结果：本研究初步确定出适合中国国情的最终完成版吞咽障碍 ICF 核心项目共34项，其中身体功能部分有18项，身体结构部分有2项，活动和参与部分有7项，环境因素部分有7项。结论：筛选出的吞咽障碍 ICF 核心项目比其他常用吞咽障碍评估量表涵盖的内容更广。