摘要
目的评估老年痴呆患者吞咽困难的发生现状及危险因素,为护理干预提供依据。方法采用临床护理用吞咽功能评估工具,对13家养老机构400例老年痴呆患者进行吞咽功能评估,并根据有无吞咽困难分为两组,对多个可能危险因素进行单因素分析和Logistic多元回归分析。结果老年痴呆患者吞咽困难发生率为52.5%,吞咽困难组的年龄、痴呆程度、基础疾病、进食依赖、进食时间、食物类型、牙齿缺失与无吞咽困难组比较,差异有统计学意义(P<0.05,P<0.01)。患者的年龄≥75岁、痴呆程度(中度、重度)、并存基础疾病(脑血管)、进食依赖(喂食)、进食时间(≥30min)、食物类型(固体食物)、牙齿缺失(6颗及以上)是痴呆患者吞咽困难的影响因素(P<0.05,P<0.01)。结论老年痴呆患者吞咽困难的发生率高,应及早发现并预防相关危险因素,多途径延缓吞咽困难的发生或进展。
Objective To determine the prevalence and risk factors of dysphagia in elderly dementia patients. Methods Four hundred elderly patients with dementia were selected from 13 older care institutions and received swallowing function test by using the Clini- cal Nursing Swallowing Assessment Tool. For statistical comparison of risk factors between patients with and without dysphagia, Pearson chi-squared test, Studentrs t test, Wileoxon rank test and Logistic regression analysis were run. Results The prevalence of dysphagia in elderly patients with dementia was 52.5G. There were significant differences in age, degree of dementia, disease his- tory, feeding types, feeding time, food types, and tooth loss observed between the group with dysphagia and the group without dysphagia （P〈0.05 ,P〈0.01）. The following were all risk factors associated with dysphagia： aged 75 years or older, moderate to severe dementia, history of cerebrovascular diseases, feeding by others, feeding time longer than 30 min, solid meal type, and missing more than 6 teeth （P〈0.05 ,P〈0.01）. Conclusion Dysphagia occurs commonly in elderly patients with dementia. Health- care providers should detect and prevent risk faetors as early as possible, so as to avoid or delay the development of dysphagia in patients with dementia.
基金
福建省卫生厅青年科研资助课题(2012-1-3)
福建省科技计划重点项目(2012Y0013)
