【作者】 王敏；

【导师】 习玲；

【作者基本信息】 山西医科大学 ， 内科学（老年医学）（专业学位）， 2021， 硕士

【摘要】 目的:调查住院老年患者吞咽障碍的现状及其影响因素,并探讨其与衰弱的相关性,为识别老年人潜在的吞咽障碍风险提供依据。方法:采用自制调查问卷方法。选取2019年12月至2020年12月在山西医科大学第一医院住院的老年患者为研究对象,根据洼田饮水实验将患者分为吞咽障碍组、无吞咽障碍组,并采用一般资料调查、综合健康评估及Fried衰弱表型评估,评价患者的整体状况。采用多因素Logistic回归分析探讨吞障发生的危险因素,采用Kendall相关性分析检验吞障与衰弱的相关性,以P<0.05为差异有统计学意义。结果:1.住院老年患者吞咽障碍、衰弱发生率分别为24.5%、21.9%;2.多因素Logistic回归分析结果显示,年龄(OR=1.135,P<0.001)、脑血管疾病(OR=0.139,P<0.001)、认知障碍(OR=0.261,P=0.006)、衰弱(OR=1.791,P=0.011)是发生吞咽障碍的危险因素;3.不同衰弱状态患者吞障发生率比较:吞障组的衰弱期患者及衰弱评估指标(如:步速减低、握力减退、活动量减少、自觉疲乏)占比高于无吞障组,差异有统计学意义。4.Kendall相关分析显示,吞咽障碍与衰弱(r=0.451,P<0.001)、体重减轻(r=0.174,P=0.004)、步速降低(r=0.339,P<0.001)、握力减退(r=0.391,P<0.001)、活动量减少(r=0.325,P<0.001)、自觉疲乏(r=0.295,P<0.001)呈正相关关系。结论:1.住院老年患者吞咽障碍发生率为24.5%,年龄、脑血管疾病、认知障碍、衰弱评分是发生吞障的独立危险因素;2.吞咽障碍与衰弱程度及衰弱指标(如步速减低、握力减退、活动量减少、自觉疲乏)呈正相关关系。更多还原

【Abstract】 Objective:To investigate the status of dysphagia and its influencing factors in hospitalized elderly patients,and to explore the correlation between dysphagia and frailty.Methods:The method of self-made questionnaire was used.Patients were randomly selected from the Department of Geriatrics in the First Hospital of Shanxi Medical University from December 2019 to December 2020.The patients were divided into dysphagia group and non-dysphagia Group according to Watian drinking water experiment,and the general data,comprehensive health evaluation and Fried weakness phenotype evaluation were used to evaluate the whole condition of patients.Multiple Logistic regression analysis was used to explore the risk factors of dyspepsia,Kendall correlation analysis was used to test the correlation between dyspepsia and weakness,and p < 0.05 was statistically significant.Results:1.The incidence of dysphagia and frailty were 24.5% and 21.9%.2.Multiple Logistic Regression analysis showed that age(or = 1.135,p < 0.001),cerebrovascular disease(or = 0.139,p < 0.001),cognitive impairment(or = 0.261,p = 0.006),weakness(or = 1.791,p = 0.011)were the risk factors of dysphagia.3.The incidence of dysphagia in patients with different debilitating states: the proportion of patients with dysphagia and the indexes of assessment of dysphagia(such as decreased walking speed,decreased grip strength,decreased activity and conscious fatigue)in patients with dysphagia group was higher than that in patients without dysphagia group.4.Kendall’s correlation analysis shows,dysphagia was positively correlated with frailty(r = 0.451,p < 0.001),weight loss(r = 0.174,p = 0.004),decreased walking speed(r = 0.339,p < 0.001),decreased grip strength(r = 0.391,p < 0.001),decreased activity(r = 0.325,p < 0.001),and perceived fatigue(r = 0.295,p < 0.001).Conclusion:1.The incidence of dysphagia in hospitalized elderly patients was 24.5%.Age,cerebrovascular disease,cognitive impairment and weakness score were independent risk factors for dysphagia.2.dysphagia and faintness degree and faintness index(such as decreased walking speed,decreased grip strength,decreased activity,perceived fatigue)show positive correlation.更多还原