糊状食物在预防无自理能力老年人食物误吸中的应用

Application of paste food in the prevention of aspiration among the elderly without self-care ability

目的为进食易误吸的无自理能力老年人选择合适的食物，以利进食，防止误吸，提高生活质量。方法选择2011年4月至2012年4月在某社会福利院医疗区住院的老年人38例为对照组，在某社区卫生服务中心康复病房住院的老年人38例为观察组，两组均给予吞咽功能评估及自理能力评估。对照组38例患者给予常规半流质饮食，观察组38例患者给予糊状食物，3个月后测定误吸次数、各项生化指标、洼田饮水等级变化等内容。结果干预后观察组患者进食误吸的次数为（12．18±10．02）次，较干预前的（33．84±33．63）次显著下降，差异有统计学意义（t=3．805，P〈0．05），对照组干预后的进食误吸次数为（31．97±21．54）次，高于观察组，差异有统计学意义（t=5．14，P〈0．05）。干预前两组血红蛋白、血清蛋白水平、皮褶厚度、上臂肌围差异无统计学意义（P〉0.05）。干预后观察组患者的血红蛋白水平、血清白蛋白水平、皮褶厚度、上臂肌围分别为（126．61±12．29）e／e，（38．35±5．95）g／L，（2．27±0．58）cm，（20．97±2．51）cm，均优于干预前的（108．53±13．50）g／L，（33．06±4．48）g／L，（2．11±0．53）em，（20．51±2．52）eln，差异有统计学意义（t分别为8．18，5．99，4．70，4．65；P〈0．05）。干预后观察组洼田饮水试验等级Ⅳ级及以上的患者比率为10．5％，较干预前的76．3％显著降低，而对照组则保持不变，干预前后均为57．9％。结论糊状食物在无自理能力老年人中具有防误吸作用，可以提高生活质量，同时规避护理风险，提高护理安全。

Objective To choose the right food for the elderly without self-care ability, in order to facilitate eating, prevent aspiration, and improve their life quality. Methods Between April 2011 and April 2011, 38 elderly patients admitted in medical districts of social welfare home were selected as control group, and 38 elderly patients admitted in rehabilitation ward of community health service centre were selected as experimental group. The swallowing function and self-care ability among elderly in the two groups were evaluated. The control group of 38 elderly were treated with semi-liquid diet, and the experimental group of 38 elderly were treated with paste food. The number of occurrences of aspiration, the changes of biochemical indicators, and the scores of water swallow test were observed and measured. Results In the experimental group, the number of occurrences of aspiration after intervention was （12. 18 ± 10.02）, decreased more than that of （33.84 ± 33.63 ） before intervention, with statistically significant difference （ t = 3. 805, P 〈 0.05 ）. After intervention, the number of occurrences of aspiration in the control group was （31.97 ± 21.54）, and higher than that in observation group, with statistically significant difference （ t = 5.14, P 〈 0.05 ）. In the experimental group, the hemoglobin levels, serum albumin levels, skinfold thickness and arm muscle circumference after intervention were better than those before intervention [ （ 126. 61 ± 12. 29 ） g/L vs （108.53± 13.50）g/L, （38.35 ±5.95）g/L vs （33.06±4.48） g/L, （2.27 ±0.58）mm vs （2.11 ±0.53） mm, （ 20.97 ± 2.51 ）cm vs （ 20.51 ± 2.52 ） em I, the differences were statistically significant （ t = 8.18, 5.99, 4.70, 4.65, respectively; P 〈 O. 05 ）. The percentage of patients with IV level and above of water swallow test in the experimental group was reduced from 76.3% before the intervention to 10.5% after the intervention, and which in the control group was 57.9% before and after the intervention. Conclusions Paste foods play a role in reducing the incidence of aspiration among the elderly without self-care ability, which can help improve their life quality, with avoiding nursing risks and improving nursing safety.