The analysis of related factors about Alzheimer's disease patients of aspiration/suffocation
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摘要: 目的 探讨患有阿尔茨海默病(Alzheimer's disease,AD)的老年患者发生误吸/窒息的影响因素。 方法 对哈尔滨医科大学附属第一医院在2013年1月-2014年12月收入院治疗的AD患者82例,采用激越问卷、智能简易精神状态筛选表、生活自理能力评定表、痴呆行为病理学评定表、患者一般情况调查表以及患者误吸/窒息风险评价估量表进行调查,并记录患者的性别、年龄、婚姻状况、教育程度、进食体位,是否有误吸史、是否使用镇静/抗癫痫类的药物以及误吸/窒息风险评估的总分,且均对其进行饮水实验,使用Pearson多元逐步回归和相关比较的分析方法对结果进行分析。 结果 误吸/窒息风险评估得分与患者的年龄、进食体位、是否有误吸史以及是否使用镇静/抗癫痫类的药物有关,而与患者的性别、婚姻状况、教育程度等没有显著相关性。饮水实验(P<0.001)、简易智能精神状态筛选表(MMSE,P=0.005)、日常生活活动能力评估(ADL,P<0.001)、Cohen-Mansfield精神激动目录(CMAI,P=0.020)以及日夜节律(P=0.008)与患者的误吸/窒息风险有显著的相关性。饮水试验、误吸/窒息史、进食体位、年龄、使用药物、ADL评分都是影响AD患者误吸/窒息风险的独立因素。 结论 以下因素都对AD患者发生误吸/窒息风险有很大的参考价值,主要包括患者饮水试验呈阳性、平卧位进食、高龄、生活自理能力低下以及使用抗精神类药或者使用镇静类药等因素。Abstract: Objective To explore the influence factors of aspiration on patients with Alzheimer's disease. Methods The patients with Alzheimer's disease in our hospital from January,2013 to December,2014 were applied with agitation questionnaire,mini mental state intelligence screening scale,ADL rating scales,dementia behavioral pathology evaluation table,general questionnaire and aspiration/suffocation risk assessment,and record the patients'gender,age,marital status,education level,eating posture,aspiration history,the use of sedative/antiepileptic and total aspiration/suffocation risk assessment,all undergoing the drinking test,via the analysis method of Pearson multiple stepwise regression and correlation. Results Aspiration/suffocation risk assessment score was related to the patient's age,eating posture,aspiration history and the use of sedation/antiepileptic drugs,but had no significant correlation with patient's sex,marital status,degree of education.Drinking water test (P<0.001),mini-mental state examination (MMSE,P=0.005),activities of daily living (ADL,P<0.001),Cohen-Mansfield agitation inventory (CMAI,P=0.020),and the circadian rhythm (P=0.008) were significantly associated with the risk of aspiration and asphyxia.Drinking test,aspiration/asphyxia,eating posture,age,drug are independent factors of aspiration/suffocation in patients with Alzheimer's disease. Conclusion The following factors on patients with Alzheimer's disease misinhalation/suffocation risk has great referential value,which mainly include positive drinking water test,supine and eating,elderly,low self-care ability and anti-psychotic drugs or the use of sedative drugs.
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Key words:
- Alzheimer's disease /
- Aspiration /
- Suffocation /
- Drinking test
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