摘要
目的探讨脑卒中吞咽障碍患者发生误吸的影响因素及预防措施。方法选择2018年1月~12月我院诊断治疗的脑卒中吞咽困难患者90例为研究对象,根据是否发生误吸分为误吸组与无误吸组。采用单因素与多因素分析脑卒中吞咽障碍患者发生误吸的影响因素,并探讨预防措施。结果单因素分析结果显示,年龄≥70岁,咳嗽反射减弱,有机械通气,双侧病变,脑干及小脑病变的患者发生误吸的比例要更高(P<0.05);而半卧位、半流质饮食的患者发生误吸的比例更低(P<0.05)。多因素分析结果显示,年龄≥70岁、咳嗽反射减弱、机械通气、双侧病变、脑干及小脑病变是脑卒中吞咽障碍患者发生误吸的独立危险因素。而半卧位、半流质饮食是保护因素(P<0.05)。结论高龄、咳嗽反射减弱、机械通气、双侧病变、脑干及小脑病变患者容易发生误吸,而半卧位、半流质饮食能减少误吸风险。临床工作中,对于有高危因素的患者更应注意预防误吸,可通过口腔护理、吞咽功能训练、半卧位、半流质饮食等措施预防误吸发生。
Objective To discuss the influencing factors and preventive measures of accidental aspiration in stroke patients with dysphagia.Methods The patients with dysphagia after stroke diagnosed and treated in hospital from January to December 2018 were selected as the study subjects.They were divided into mistake inhalation group and no mistake inhalation group according to the occurrence of mistake inhalation.Univariate and multivariate analysis was used to analyze the factors affecting the occurrence of aspiration in stroke patients with dysphagia,and preventive measures were explored.Results Univariate analysis showed that:Patients with age over 70 years old,cough reflex weakened,mechanical ventilation,bilateral lesions,brain stem and cerebellumhad a higher proportion of accidental aspiration(P<0.05);The proportion of accidental aspiration was lower in patients with half-lying position and half-fluid diet(P<0.05).The results of multivariate analysis showed that:Age over 70,weakened cough reflex,mechanical ventilation,bilateral lesions,brain stem and cerebellum lesionswere independent risk factors for aspiration in stroke patients with dysphagia,while semi-supine position and semi-fluid diet were protective factors(P<0.05).Conclusion Patients with older age,weakened cough reflex,mechanical ventilation,bilateral lesions,brain stem and cerebellum lesionsare prone to aspiration,and semi-recumbent and semi-liquid diet can reduce the risk of aspiration.In clinical work,more attention should be paid to the prevention of aspiration in patients with high risk factors.Oral nursing,deglutition training,semi-recumbent position and semi-liquid diet is used to prevent aspiration.
作者
成冲
李慧慧
郎春霞
CHENG Chong;LI Hui-hui;LANG Chun-xia(Nursing Department,Jiyuan People's Hospital,Henan Province,459000)
出处
《临床护理杂志》
2019年第5期20-23,共4页
Journal of Clinical Nursing
基金
河南省科技发展计划项目(162102212337)
关键词
脑卒中
吞咽障碍
食物吸入
stroke
deglutition disorders
food inhalation
