本文選題：吸入性肺炎 + 床旁飲水試驗��； 參考：《遼寧醫(yī)學院》2012年碩士論文

【摘要】：目的 隨著我國老齡化進程的加快，老年吸入性肺炎的發(fā)生和發(fā)展正逐漸受到重視，但對吸入性肺炎的診斷仍局限于臨床癥狀及體征的觀察，尚缺乏統(tǒng)一的“金標準”。床旁飲水試驗操作簡單、方便，患者耐受性好，為此本文探討床旁飲水試驗的操作方法和觀察指標，同時結合纖維支氣管鏡檢查對吸入性肺炎患者的預防和診斷的正確性進行評估。 方法 明確診斷吸入性肺炎（AP）患者46例，社區(qū)獲得性肺炎（CAP）患者30例，慢性阻塞性肺疾�。–OPD）患者21例入選本次研究。3組患者在病情穩(wěn)定后、意識清醒的狀態(tài)下，由同一名醫(yī)生分別進行飲水試驗，記錄所用時間、觀察吞咽過程以及飲水時出現的不正常的現象，，并進行數據統(tǒng)計。在吸入性肺炎組患者知情同意的情況下，在禁食2小時以后行纖維支氣管鏡檢查，做FEES評分，觀察嘔吐反射和聲門閉合情況。 結果 3組患者年齡分布無統(tǒng)計學差異（p=0.17）、CURB-65評分結果無統(tǒng)計學差異（p=0.42）。3組患者飲水相同體積時所用時間顯著不同，并具有統(tǒng)計學意義（p＜0.01）。并且，吸入性肺炎組患者出現中斷或者哽噎、不正常吞咽現象的頻率也明顯增高。吸入性肺炎組患者同意行纖維支氣管鏡檢查者共42例，FEES評分平均值為5.50±1.35，有6例（14.29%）評分≤4分，36例＞4分。以AP患者喝完10ml溫水所用時間＞5s為標準，纖維支氣管鏡檢查和床旁飲水試驗兩種方法診斷吸入性肺炎的結果相同（p＞0.1）。 床旁飲水試驗不僅可以用于輔助診斷吸入性肺炎患者，還可以指導吸入性肺炎的分級預防和治療，有較好的臨床應用價值。輔助纖維支氣管鏡檢查可增加其診斷的可靠性。
[Abstract]:PurposeWith the acceleration of aging process in China, the occurrence and development of inhaled pneumonia in the elderly is being paid more and more attention. However, the diagnosis of aspiration pneumonia is still limited to the observation of clinical symptoms and signs, and there is still a lack of unified "gold standard".The operation of bedside drinking water test is simple, convenient and patient tolerance is good. Therefore, this paper discusses the operation method and observation index of bedside drinking water test.At the same time, the prevention and diagnosis of aspiration pneumonia were evaluated by fiberoptic bronchoscopy.MethodForty-six patients with inhaled pneumonia (APP), 30 patients with community-acquired pneumonia (CAP) and 21 patients with chronic obstructive pulmonary disease (COPD) were included in this study group.The drinking test was conducted by the same doctor to record the time used to observe the abnormal phenomena in the process of swallowing and drinking water and to carry out statistics.With the informed consent of the patients with aspiration pneumonia, fiberoptic bronchoscopy, FEES score, vomiting reflex and glottic closure were performed 2 hours after fasting.ResultThere was no statistical difference in age distribution among the three groups. There was no statistical difference in the score of CURB-65. There was no significant difference in the time used for drinking water of the same volume in the p0. 42. 3 group, and the difference was statistically significant (P < 0. 01).The frequency of abnormal swallowing was also significantly increased in patients with aspiration pneumonia.The average FEES score of 42 patients with aspiration pneumonia was 5.50 鹵1.35, with 6 patients with 14. 29) scores 鈮

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