慢性阻塞性肺疾病患者吞咽障碍的发生现状及影响因素研究

Research on present status and influencing factors of dysphagia for patients with chronic obstructive pulmonary disease

目的调查慢性阻塞性肺疾病患者吞咽障碍的发生现状,并分析其影响因素。方法采用便利抽样法,回顾性收集慢性阻塞性肺疾病患者的临床资料,根据是否发生吞咽障碍分为吞咽障碍组和非吞咽障碍组,采用单因素分析、Logistic回归分析吞咽障碍的影响因素。结果共251例患者发生吞咽障碍,发生率为57.05%。Logistic回归分析显示,疾病分期(OR=3.244)、mMRC分级(mMRC分级3级OR=3.243,mMRC分级4级OR=3.556)、静息呼吸频率(OR=2.231)、合并呼吸衰竭(OR=3.800)、合并胃食管反流(OR=3.334)及使用无创机械通气(OR=0.332)是慢性阻塞性肺疾病患者吞咽障碍的影响因素(P<0.05)。结论慢性阻塞性肺疾病患者吞咽障碍的发生率高,慢性阻塞性肺疾病急性加重、呼吸困难症状严重、呼吸频率快、合并呼吸衰竭、合并胃食管反流是慢性阻塞性肺疾病患者吞咽障碍的危险因素,而使用无创机械通气是慢性阻塞性肺疾病患者吞咽障碍的保护性因素。

Objective To investigate the present status on dysphagia for patients with chronic obstructive pulmonary disease(COPD)and analyze its influencing factors.Method Collect clinical information of patients with COPD retrospectively and divide patients into dysphagia group and non-dysphagia group by convenient sampling.Analyze the influencing factors of dysphagia by single factor analysis and Logistic regression analysis.Result There are 251 cases of dysphagia and the incidence is 57.05%.Logistic regression analysis shows that disease stage(OR=3.244),mMRC grade(grade 3 on mMRC,OR=3.243;grade 4 on mMRC,OR=3.556),resting respiratory rate(OR=2.231),complicating with respiratory failure(OR=3.800),complicating with gastroesophageal reflux(OR=3.334)and using non-invasive mechanical ventilation(OR=0.332)are influencing factors of dysphagia for patients with COPD(P<0.05).Conclusion The incidence of dysphagia for patients with COPD is high.Acute exacerbation of COPD,severe symptom of dyspnea,rapid respiratory rate,complicating with respiratory failure and complicating with gastroesophageal reflux are risk factors of dysphagia for patients with COPD.Using non-invasive mechanical ventilation is a protective factor of dysphagia for patients with COPD.