误吸风险评估与饮食分级护理预防高龄患者误吸

Aspiration risk assessment and graded dietary care to prevent aspiration in elderly patients

目的探讨饮食分级护理预防高龄患者进食误吸的效果。方法将126例高龄患者按入院时间排序分为干预组（2013年7～12月,63例）和对照组（2013年1～6月,63例）。对照组按照常规护理,干预组入院时行吞咽功能评分和误吸风险等级划分,并在此基础上根据误吸风险等级实施饮食分级护理。比较两组患者干预期间进食时误吸发生情况。结果两组入院时误吸风险比较,差异无统计学意义（P〉0.05）。干预后,对照组共发生误吸170次,误吸发生率为5.60%,其中呛咳152次,噎食17次,窒息1次;干预组共发生误吸28次,误吸发生率为0.94%,其中呛咳25次,噎食3次,无窒息发生。两组误吸发生率比较差异有统计学意义（P〈0.01）。结论对高龄患者行误吸风险分级,并实施相应的饮食分级护理措施,可有效降低误吸风险,保障高龄患者进食安全。

Objective To explore the application effect of graded dietary care on aspiration prevention in elderly patients.Methods A total of 126 elderly patients were selected and divided into an intervention group（admitted during July to December in 2013,63 cases）and a control group（admitted during January to June in 2013,63 cases）according to hospitalization time.The intervention group were assessed at admission with Standardized Swallowing Assessment（SSA）to screen the risk of aspiration,then they received graded dietary care based on the assessment results of aspiration risks.The control group received conventional aspiration prevention measures.The incidence of aspiration was observed during the intervention.Results The aspiration risk between the two groups had no significant difference on admission（P〈0.05）.After the intervention,there were 170 times of aspiration（152 coughings,17 chokings,and 1asphyxia）,with the incidence rate of aspiration being 5.60%,in the control group,and 28 times of aspiration（25 coughings,3 chokings,0 asphyxia）,with the incidence rate of aspiration being 0.94%,in the intervention group.The rates had significant difference（P〈0.01）.Conclusion Graded dietary care based on aspiration risk assessment can effectively minimize aspiration risk,reduce the incidence rate of aspiration in the elderly and ensure their safety.