老年人误吸危险因素及临床诊治进展 - 欢迎访问中华老年多器官疾病 .doc

·综 述· 老年人误吸危险因素及临床诊治进展 刘媛媛1,2，何晓乐1，李晓玲1，傅卫红3，程 珂1，王晓明* （1第四军医大学西京医院老年病科，西安710032；2解放军第323医院干部病房，西安 710054；3解放军第451医院干部病房，西安 710054） 【摘 要】误吸是指唾液、鼻咽分泌物、细菌、食物等经喉头进入呼吸道的异常过程，是老年人常见临床问题。它所导致的窒息、吸入性肺炎等并发症是老年人常见死因。随着我国人口老龄化程度加重，老年人发生误吸的事件不断增加，为此，本文就误吸发生的危险因素及临床诊疗措施进行综述，以期为有效防治老年人误吸提供依据。 【关键词】误吸；吞咽；危险因素；诊断；治疗学；老年人 【中图分类号】 R333.1; R592 【文献标识码】 A 【DOI】 ? Risk factors analysis and progress on clinical diagnosis and treatment for aspiration in elderly LIU Yuan-Yuan1,2, HE Xiao-Le1, LI Xiao-Ling1, FU Wei-Hong3, CHENG Ke1, WANG Xiao-Ming1* (1Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, China; 2Cadre’s Ward, No. 323 Hospital of PLA, Xi’an 710054, China; 3Cadre’s Ward, No. 451 Hospital of PLA, Xi’an 710054, China) 【Abstract】 Aspiration is defined as the abnormal process of inhalations, such as saliva, nasopharyngeal secretions, bacteria, foods and so on entering the respiratory tract through the throat, and is a usually troublesome for the elderly in clinical practice. Complications resulting from aspiration, such as asphyxia and pneumonia, are common causes of death in the elderly. As the population ageing, the incidence of aspiration in the elderly is increased. So, with the aim of effectively preventing and treating aspiration in the elderly, we analyzed its risk factors and reviewed its clinical management for diagnosis and treatments. 【Key words】 aspiration; deglutition; risk factors; diagnosis; therapeutics; aged This work was supported by the Special Project of Health Industry Scientific Research From National Health and Family Planning Commission of China (201302008). Corresponding author: WANG Xiao-Ming, E-mail: xmwang@fmmu.edu.cn 误吸（aspiration）是指进食（或非进食）时，在吞咽过程中有数量不一的液体或固体食物（甚至还可包括分泌物或血液等）进入到声门以下的气道。老年人由于机体组织结构衰老和生理功能减退，误吸发生率较高[1,2]。导致老年人发生误吸的危险因素有脏器功能减退、相关疾病、药物及护理因素等。目前临床上根据患者是否有明显症状将误吸分为显性误吸和隐性误吸[3]，有报道称隐性误吸发生率高达40%～70%[4]，明显高于显性误吸。如何早期诊断，及时干预，避免出现窒息、吸入性肺炎等并发症是临床医师关注的焦点。本文拟对老年人误吸危险因素及其临床诊治方法进行综述和评价。 1