潍坊市养老院老年人吞咽障碍与误吸调查

doi:10.3969/j.issn.1006-9771.2022.04.014

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (4): 467-472.doi: 10.3969/j.issn.1006-9771.2022.04.014

潍坊市养老院老年人吞咽障碍与误吸调查

张萍萍¹,张婷¹,冯海洋¹,李贞蓉¹,陈萍²,李涛³,鲁德志⁴(),王孝文¹()

1.潍坊医学院,山东潍坊市 261021
2.潍坊医学院附属医院,山东潍坊市 261021
3.上海交通大学医学院附属新华医院,上海市 200444
4.上海大学医学院,上海市 200444

收稿日期:2021-09-05 修回日期:2022-02-10 出版日期:2022-04-25 发布日期:2022-05-05
通讯作者: 鲁德志,王孝文 E-mail:dezhi_lu@163.com;wangxiaowen2003@126.com
作者简介:张萍萍(1996-),女,汉族,江苏镇江市人,硕士,初级治疗师,主要研究方向：吞咽康复及呼吸康复。
基金资助:
国家自然科学基金青年科学基金项目(81902195);上海交通大学中国医院发展研究院医院管理建设项目(CHDI-2021-B-33);潍坊市软科学研究计划项目(2021RKX071);潍坊医学院校级大学生创新创业训练计划项目(X2021137)

Investigation on dysphagia and aspiration among the elderly in nursing home in Weifang, Shandong, China

ZHANG Pingping¹,ZHANG Ting¹,FENG Haiyang¹,LI Zhenrong¹,CHEN Ping²,LI Tao³,LU Dezhi⁴(),WANG Xiaowen¹()

1. Weifang Medical University, Weifang, Shandong 261021, China
2. Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261021, China
3. Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200444, China
4. Medicine School of Shanghai University, Shanghai 200444, China

Received:2021-09-05 Revised:2022-02-10 Published:2022-04-25 Online:2022-05-05
Contact: LU Dezhi,WANG Xiaowen E-mail:dezhi_lu@163.com;wangxiaowen2003@126.com
Supported by:
National Natural Science Foundation of China (Youth)(81902195);Hospital Management and Construction Project of China Hospital Development Research Institute of Shanghai Jiaotong University(CHDI-2021-B-33);Weifang Soft Science Research Project(2021RKX071);School Innovation and Entrepreneurship Training Program of Weifang Medical University(X2021137)

摘要/Abstract

摘要：

目的调查潍坊市养老院老年人吞咽障碍与误吸的发生情况及具体表现。方法 2021年1月至6月,随机抽取潍坊市10家养老院入住的837位老年人,采用基本情况调查问卷、Fried衰弱表型、Ohkuma问卷和容积-黏度吞咽测试进行调查。结果养老院老年人吞咽障碍与误吸的发生率分别为44.2%、12.3%。不同年龄和健康状况老年人的吞咽障碍发生率有显著性差异(χ² > 8.437, P<0.05)。男性吞咽障碍与误吸的发生率均高于女性(χ² > 4.060, P < 0.05)。男性口腔期吞咽功能障碍发生率显著高于女性,食管期吞咽功能障碍发生率显著低于女性(χ² > 20.830, P<0.001)。患有脑卒中、阿尔茨海默病和帕金森病的老年人以口腔期功能障碍为主(χ²=27.579, P<0.001),患有慢性呼吸道疾病老年人以咽期和气道保护功能障碍为主(χ² > 20.241, P<0.01)。结论养老院老年人吞咽障碍与误吸发生率较高,不同性别、基础疾病间的吞咽障碍表现不同。

关键词: 吞咽障碍, 误吸, 老年人, 衰弱, 调查

Abstract:

Objective To investigate the occurrence and characteristics of dysphagia and aspiration in the elderly in nursing home in Weifang, Shandong, China.Methods From January to June, 2021, 837 elderly people from 10 nursing homes in Weifang were randomly selected and investigated with general situation questionnaire, Fried Frailty Phenotype, Ohkuma questionnaire and Volume-Viscosity Swallowing Test.Results The prevalence of dysphagia and aspiration was 44.2% and 12.3% respectively. There were significant differences in the prevalence of dysphagia among ages and health condition (χ² > 8.437, P<0.05). The prevalence of dysphagia and aspiration was higher in men than in women (χ² > 4.060, P < 0.05). The incidence of oral dysphagia was higher in men than in women, and the incidence of esophageal dysphagia was lower (χ² > 20.830, P<0.001). Oral dysphagia was predominant in the elderly with stroke, Alzheimer's disease, and Parkinson's disease (χ²=27.579, P<0.001), and esophageal dysphagia and airway protection dysfunction were predominant in the elderly with chronic respiratory disease (χ² > 20.241, P<0.01).Conclusion The dysphagia and aspiration are prevalent in the elderly in nursing homes, and varies with different genders and basic diseases.

Key words: dysphagia, aspiration, aged, frailty, investigation

张萍萍,张婷,冯海洋,李贞蓉,陈萍,李涛,鲁德志,王孝文. 潍坊市养老院老年人吞咽障碍与误吸调查[J]. 《中国康复理论与实践》, 2022, 28(4): 467-472.

ZHANG Pingping,ZHANG Ting,FENG Haiyang,LI Zhenrong,CHEN Ping,LI Tao,LU Dezhi,WANG Xiaowen. Investigation on dysphagia and aspiration among the elderly in nursing home in Weifang, Shandong, China[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(4): 467-472.

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潍坊市养老院老年人吞咽障碍与误吸调查

Investigation on dysphagia and aspiration among the elderly in nursing home in Weifang, Shandong, China

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项目	n	吞咽障碍	误吸	χ²值^a	P值^a	χ²值^b	P值^b
性别				4.060	0.044	4.486	0.034
男	350	169	53
女	487	201	50
年龄/岁				8.437	0.038	5.621	0.132
60~69	78	41	9
70~79	160	65	28
80~89	400	163	41
90~	199	101	25
衰弱				73.931	< 0.001	104.409	< 0.001
否	427	243	4
是	410	127	99
疾病				58.409	< 0.001	51.996	< 0.001
脑卒中	162	94	37
阿尔茨海默病	56	32	6
帕金森病	38	26	5
慢性呼吸道疾病	54	36	18
其他慢性疾病	272	102	21
无	255	80	16

项目	n	并发症	咽期	口腔期	食管期	气道保护	并发症		咽期		口腔期		食管期		气道保护
项目	n	并发症	咽期	口腔期	食管期	气道保护	χ²值	P值	χ²值	P值	χ²值	P值	χ²值	P值	χ²值	P值
性别							0.754	0.385	2.275	0.131	30.180	< 0.001	20.830	< 0.001	2.181	0.140
男	169	11	54	129	5	18
女	201	7	50	154	36	32
年龄/岁							3.080	0.379	7.457	0.059	13.524	0.004	7.891	0.048	0.874	0.832
60~69	41	2	17	24	2	7
70~79	65	3	23	45	3	7
80~89	163	4	38	127	18	22
90~	101	7	26	86	17	14
疾病							9.423	0.093	79.334	< 0.001	27.579	< 0.001	8.726	0.121	20.241	0.001
脑卒中	94	7	41	75	5	16
阿尔茨海默病	32	1	4	26	1	7
帕金森病	26	1	7	22	3	4
慢性呼吸道疾病	36	4	28	15	4	14
其他慢性疾病	102	1	15	83	17	9
无	80	2	9	62	9	9
总计	370	18	104	283	41	59

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