王琴 朱齐琦

[摘要] 目的 分析影响老年患者发生吸入性肺炎的主要危险因素。 方法 选取2019年2月至2020年2月我院收治的60例老年吸入性肺炎患者和60例正常老年体检人员，采用调查问卷的方式，具体调查患者的年龄、是否出现意识障碍、是否长期卧床、是否出现胃食管反流等，找到影响吸入性肺炎出现的因素。 结果 ①年龄超过75岁，有意识障碍、吞咽障碍、长期卧床、胃食管反流等因素均为吸入性肺炎产生的危险因素;②针对吸入性肺炎老年患者开展多因素分析结果发现，意识障碍、年龄和吞咽障碍是最为关键的独立危险因素。 结论 老年患者发生吸入性肺炎的相关因素较多，独立危险因素主要是吞咽障碍、年龄以及意识障碍，所以必须要做好这几个方面的预防措施，如调整现在的饮食方式、适当给予管饲饮食以及吞咽功能的训练等，通过制订预防措施减少老年患者吸入性肺炎的发生率。

[关键词] 老年患者;吸入性肺炎;危险因素;吞咽障碍

[中图分类号] R563.1          [文献标识码] B          [文章编号] 1673-9701（2021）31-0048-04

[Abstract] Objective To analyze the main risk factors affecting the occurrence of aspiration pneumonia in elderly patients. Methods A total of 60 elderly patients with aspiration pneumonia admitted from February 2019 to February 2020 were enrolled in the study. Another 60 elderly people who passed the physical examination were enrolled at the same time. A questionnaire was used to specifically investigate the patients′ age， consciousness disorder， whether they were bedridden for a long time， and the presence or absence of gastroesophageal reflux，so as to find out the factors affecting the occurrence of aspiration pneumonia. Results ①Age over 75 years， presence of consciousness disorder，dysphagia，long-term bedridden，and gastroesophageal reflux were related risk factors for the occurrence of aspiration pneumonia. ②A multifactorial analysis showed that consciousness disorder， age and dysphagia were the most critical independent risk factors affecting the occurrence of aspiration pneumonia in elderly patients. Conclusion There are many related risk factors for the occurrence of aspiration pneumonia in elderly patients. The independent risk factors are mainly dysphagia， age and consciousness disorder， so it is necessary to take preventive measures in these aspects，such as adjusting the current diet， giving appropriate tube feeding diet and swallowing function training. At the same time， preventive measures should be formulated to reduce the incidence of aspiration pneumonia in elderly patients.

[Key words] Elderly patients; Aspiration pneumonia; Risk factors; Dysphagia

吸入性肺炎（Aspiration pneumonia，AP）是指患者吸入異物，同时还将口咽或胃内容物等刺激性的固体、液体等进入到下呼吸道中，在肺内出现寄生菌[1]。患者会先出现化学性肺部损伤或肺炎，然后再出现细菌性肺炎。这也是老年患者肺部感染十分常见的类型和重要的死亡原因。有研究报道，在吸入性肺炎中显性只占10%，而隐性误吸占70%以上[2]。隐性误吸的患者一般不会出现咳嗽或其他的不适症状，但却增加吸入性肺炎的发生率。……