新型冠状病毒肺炎疫情期间老年人进食安全护理

doi:10.16150/j.1671-2870.2022.02.036

摘要/Abstract

摘要：

对2例新型冠状病毒（新冠）肺炎住院老年患者的吞咽功能障碍,采取特殊护理措施,并对经验进行总结,从而为有效减少误咽、呛咳,保障老年人进食安全提供护理经验。护理要点包括吞咽功能评估,根据吞咽障碍程度制定及实施相应的康复训练及护理干预,在新冠肺炎导致患者食欲降低的情况下对老年人进餐帮助的护理措施以及防止老年新冠肺炎患者因呛咳加重肺部感染的重点措施。患者经吞咽功能训练和科学正确的进餐帮助,在住院期间未发生误咽、呛咳,未发生或加重肺部感染,吞咽功能有所改善,营养状况良好,新冠肺炎均顺利治愈,康复出院。

关键词: 老年人, 新型冠状病毒肺炎, 吞咽功能障碍, 进食安全, 护理

中图分类号:

R715.2

张红, 朱梦梦. 新型冠状病毒肺炎疫情期间老年人进食安全护理[J]. 诊断学理论与实践, 2022, 21(02): 277-280.

ZHANG Hong, ZHU Mengmeng, et al . Safety nursing for eating in the elderly during the COVID-19 pandemic[J]. Journal of Diagnostics Concepts & Practice, 2022, 21(02): 277-280.

图/表 1

参考文献 16

[1]	蒋婷. 呛咳、气道异物, 老人呼吸道的“致命杀手”[J]. 祝您健康, 2020(2):46-48.
	Jiang T. Choking cough and airway foreign bodies are the "fatal killer" of the respiratory tract of the elderly[J]. Zhu Nin Jian Kang, 2020(2):46-48.
[2]	魏媛, 李红. 吞咽功能训练对老年脑卒中吞咽障碍患者的影响[J]. 解放军护理杂志, 2018, 35(24):34-38.
	Wei Y, Li H. Effect of swallowing function training on elderly patients with dysphagia after stroke[J]. Nurs J Chin People′s Liberation Army, 2018, 35(24):34-38.
[3]	钱秀芳, 金晓红, 郁清. 水吞咽试验在降低老年患者吸入性肺炎发生中的作用[J]. 护理管理杂志, 2013, 13(2):149-150.
	Qian XF, Jin XH, Yu Q. Role of water swallowing test in reducing the incidence of aspiration pneumonia in elderly patients[J]. J Nurs Adm, 2013, 13(2):149-150.
[4]	纳金花. 吞咽困难怎么办[J]. 保健医苑, 2020(1):28-29.
	Na JH. How does dysphagia do[J]. Health Care, 2020(1):28-29.
[5]	李莎, 鄂建设, 秦彩红. 吞咽障碍患者生活质量调查及其影响因素分析[J]. 重庆医学, 2017, 46(27):3816-3818.
	Li S, E JS, Qin CH. Quality of life in patients with dysphagia and its influencing factors[J]. Chongqing Med, 2017, 46(27):3816-3818.
[6]	崔丽萍, 冯晓芳. 综合康复训练改善老年吞咽障碍的效果研究[J]. 中华现代护理杂志, 2019(15):1892-1895.
	Cui LP, Feng XF. Effect of comprehensive rehabilitation training on dysphagia in the elderly[J]. Chin J Mod Nurs, 2019(15):1892-1895.
[7]	裴华, 张来华. 吞咽功能训练在老年吞咽功能障碍患者中的应用[J]. 上海护理, 2016, 16(1):12-14.
	Pei H, Zhang LH. Application of swallowing function training in elderly patients with swallowing dysfunction[J]. Shanghai Nurs, 2016, 16(1):12-14.
[8]	孙素娟, 冯春兰. 老年病人食物误吸的预防及护理[J]. 承德医学院学报, 2002, 19(3):227-228.
	Sun SJ, Feng CL. Prevention and nursing of food aspiration in elderly patients[J]. J Chengde Med Coll, 2002, 19(3):227-228.
[9]	高薇薇, 周静, 陆蔚, 等. 老年吞咽障碍患者的吞咽功能康复研究[J]. 中国地方病防治杂志, 2018, 33(6):678-679.
	Gao WW, Zhou J, Lu W, et al. Rehabilitation of swallowing function in elderly patients with dysphagia[J]. Chin J Control Endem Dis, 2018, 33(6):678-679.
[10]	林莹, 宋曼莉, 冯星. 基础吞咽训练对脑卒中急性期鼻饲患者吞咽功能康复的临床研究[J]. 实用临床护理学电子杂志, 2018, 3(39):56,59.
	Lin Y, Song ML, Feng X. Clinical study of basic swallowing training on the rehabilitation of swallowing function in patients with acute stroke by nasal feeding[J]. J Clin Nurs Practicality, 2018, 3(39):56,59.
[11]	周光维, 唐靖. 综合护理干预应用于脑卒中继发癫痫的作用[J]. 现代养生B, 2015(11):105.
	Zhou GW, Tang J. Effect of comprehensive nursing intervention on epilepsy secondary to stroke[J]. Health Care Today, 2015(11):105.
[12]	黄倩, 黄梅. 间歇性经口胃管置管鼻饲在脑卒中吞咽障碍患者中的应用[J]. 当代护士(上旬刊), 2020, 27(11):150-152.
	Huang Q, Huang M. Application of intermittent oral gastric tube nasal feeding in patients with dysphagia after stroke[J]. Today Nurse, 2020, 27(11):150-152.
[13]	戴卉, 周辰, 潘晓东, 等. 吞咽功能训练预防老年吞咽障碍病人肠内营养误吸的研究[J]. 实用老年医学, 2018, 32(3):293-294.
	Dai H, Zhou C, Pan XD, et al. Study on the prevention of swallowing dysfunction in elderly patients with enteral nutrition training[J]. Pract Geriatr, 2018, 32(3):293-294.
[14]	黄一鲜. 心理护理对老年吞咽障碍患者功能恢复的影响[J]. 中国老年保健医学, 2016, 14(3):102-103.
	Huang YX. Effect of psychological nursing on functional recovery of elderly patients with dysphagia[J]. Chin J Geriatr Care, 2016, 14(3):102-103.
[15]	陈彩虹, 谭壮丽. 护理干预在改善老年脑卒中患者吞咽功能障碍中的应用[J]. 深圳中西医结合杂志, 2016, 26(16):155-156.
	Chen CH, Tan ZL. Application of nursing intervention in improving swallowing dysfunction in elderly stroke patients[J]. Shenzhen J Integr Tradit Chin West Med, 2016, 26(16):155-156.
[16]	王新新. 老年人吞咽异常及相关知识知晓情况调查[D]. 长春中医药大学, 2019.
	Wang XX. Investigation on the awareness of dysphagia and related knowledge in the elderly[D]. Changchun Univ of Chin Medi, 2019.

分级	表现	胃管置入
1级（优）	能一次性饮用完成	不需要
2级（良）	在没有发生咳喘的情况下, 分2次咽下	不需要
3级（中）	发生咳喘,但仅用1次咽下	建议留置胃管
4级（可）	有咳喘,分2次咽下	建议留置胃管
5级（差）	没有全部咽下,且发生严重的呛咳	建议留置胃管