慢性阻塞性肺疾病患者口腔功能状况的影响因素分析

Analysis of risk factors for oral function in patients of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)住院患者口腔功能状态现状及影响因素。方法采用便利抽样法,选择2022年9月—2023年7月在深圳市龙岗区某三甲医院呼吸内科、胸外科的老年COPD住院患者191例作为研究对象。使用一般资料调查表、日常生活自理能力评估量表(BADL)、反复唾液吞咽试验(RSST)、改良版呼吸困难量表(mMRC)、改良版Beck口腔评分量表进行调查及评估。采用单因素分析老年COPD住院患者口腔功能状态的影响因素,采用Logistic回归分析老年COPD住院患者口腔功能状态的影响因素。结果191例老年COPD患者中,入院时、住院第3天(D3)、住院第5天(D5)、出院的Beck口腔评分分别为(10.79±2.51),(10.91±2.82),(11.21±2.30),(10.83±2.55)分,比较差异无统计学意义(P>0.05)。单因素分析结果显示,COPD患者在D3、D5、出院时,Beck口腔功能状态的影响因素有:年龄、性别、婚姻状况、牙齿缺失情况、抽烟史以及生活自理能力影响,差异具有统计学意义(P<0.05)。二元Logistic回归分析结果显示,年龄、吸烟状况、牙齿缺失数量、生活自理能力是COPD住院患者口腔功能状态的影响因素(P<0.05)。结论老年COPD患者口腔卫生状况较差,且受到年龄、吸烟情况、牙齿缺失、生活自理能力的影响,应采取针对性预防和干预策略,改善老年COPD住院患者的口腔卫生状况,以降低COPD患者发生并发症的风险。

Objective To investigate the status quo and influencing factors of oral function in hospitalized patients of chronic obstructive pulmonary disease(COPD).Methods A total of 191 patients with COPD who were hospitalized in the Respiratory Department and Thoracic Surgery Department of a hospital in Longgang,Shenzhen from September 2022 to July 2023 were selected by convenience sampling.The general data questionnaire,the Barthel index of activity of daily living(BADL)the repetitive saliva swallowing test(RSST),modified Medical Research Council Dyspnea Scale(mMRC),the Modified Beck Oral Assessment Scale(BOAS)were used for investigation and evaluation.Single factor analysis was used to analyze the influencing factors of oral function status in elderly COPD patients,and logistic regression was used to analyze the independent risk factors affecting oral function status in elderly COPD patients.Results Among 191 elderly patients with COPD,the BOAS scores were(10.79±2.51),(10.91±2.82),(11.21±2.30),(10.83±2.55)at admission,the 3rd day,the 5th day and discharged day,respectively,with no statistical significance.The results of univariate analysis indicated that the independent risk factors of Beck oral function status in COPD patients at D3,D5 and dis,age,marital status,tooth loss,smoking history and Barthel index score,and the differences were stacharge were gendertistically significant(P<0.05).Binary logistic regression analysis indicated that age,smoking status,tooth loss and Barthel index score were independent risk factors for oral function status in hospitalized patients with COPD(P<0.05).Conclusions Elderly patients with COPD have poor oral health status,which is affected by patient’s age,smoking history,tooth loss and self-care ability.Targeted prevention and intervention strategies should be adopted to improve the oral health status of hospitalized patients with COPD,so as to reduce the COPD patient’s risk of complications.