高龄脑卒中吞咽障碍患者误吸的影响因素分析

Analysis of infl uencing factors of aspiration in elderly stroke patients with dysphagia

目的分析高龄脑卒中吞咽障碍患者误吸的影响因素,为制定防护策略,降低该类患者误吸提供依据。方法选取医院2019年4月—2020年4月住院的高龄脑卒中吞咽障碍患者111例,对患者的性别、年龄、既往病史、鼻胃管进食、口腔运送时间、镇静药物或抗精神病药物、神志、是否合并多种高龄慢性疾病、进食卧位、是否有人工气道等数据进行统计学分析,筛选高龄脑卒中吞咽障碍患者误吸的影响因素。结果单因素分析显示,年龄≥75岁、气管切开与机械通气、仰卧位、进食过快、口腔运送时间大于1.5 s、咽启动延迟、会厌谷残留是影响高龄脑卒中吞咽障碍患者误吸的影响因素(P<0.05)。多因素Logistic回归分析显示,年龄≥75岁、气管切开与机械通气、仰卧位、口腔运送时间大于1.5 s是高龄脑卒中吞咽障碍患者的影响因素(P<0.05)。结论高龄吞咽障碍的误吸发生率较高,护理人员需加强对上述高危因素的识别与防护,及时消除高危因素,降低误吸发生风险。

Objective To analyze the infl uencing factors of aspiration in elderly stroke patients with dysphagia,and provide a basis for formulating protective strategies to reduce aspiration in such patients.Methods A total of 111 elderly stroke patients with dysphagia who were hospitalized in hospital from April 2019 to April 2020 were selected,and a statistical analysis on the gender,age,past medical history,nasogastric tube feeding,oral delivery time,sedative drugs or antipsychotic drugs,mentality,whether combined with multiple chronic diseases of the elderly,eating and lying position,whether there is artificial airway,etc.,were carried out to screen the infl uencing factors of aspiration in elderly stroke patients with dysphagia.Results Univariate analysis showed that the age≥75 years old,tracheotomy and mechanical ventilation,supine position,fast eating,oral delivery time greater than 1.5 seconds,delayed pharynx initiation,and epiglottic vallecula residual,were the infl uencing factors that aff ected aspiration in elderly stroke patients with dyphagia(P<0.05).Multivariate Logistic regression analysis showed that the age≥75 years old,tracheotomy and mechanical ventilation,supine position and oral delivery time greater than 1.5 seconds were the infl uencing factors that aff ected aspiration in elderly stroke patients with dyphagia(P<0.05).Conclusion The incidence of aspiration in the elderly with dysphagia was high.Nursing staff need to strengthen the identifi cation and protection of the above-mentioned high-risk factors,eliminate the highrisk factors in time,and reduce the risk of aspiration.