“ASK-T”防误吸管理模式在降低老年慢性阻塞性肺疾病合并吞咽障碍患者误吸风险中的应用

doi:10.3969/j.issn.1006-5725.2025.03.020

Abstract

Abstract:

Objective To explore the application effect of the "ASK-T" aspiration prevention management model in reducing the risk of aspiration in elderly patients with chronic obstructive pulmonary disease （COPD） complicated by dysphagia. Methods 196 of 409 COPD patients with aspiration risk admitted to the Respiratory Disease Department of Guangdong Provincial Hospital of Chinese Medicine， Higher Education Mega Center Hospital from July 2021 to June 2024 were selected as the study object， and 102 COPD patients with aspiration risk admitted from July 2021 to December 2022 were set as the pre-improvement group. The patients in this group received the original nursing process and management mode of the department during hospitalization. 94 COPD patients with aspiration risk admitted from January 2023 to June 2024 were set as the improved group， and the patients in this group were introduced into the department and implemented an innovative improvement project： "ASK-T" anti-aspiration management mode and then received nursing management. Patients in both groups were observed and followed up for 4 weeks. The risk grade of aspiration， SSA score， DHI score， aspiration pneumonia and aspiration pneumonia， nutritional status and satisfaction after intervention were compared between the two groups. Result The comparison showed that after the implementation of improvement measures， the aspiration risk grade of patients in the improved group was significantly lower than that in the pre-improvement group （P < 0.05）， and the SSA score， DHI score and total DHI score of patients in the 2 groups were significantly lower than that before intervention （P < 0.05）. The SSA score， DHI score and DHI total score in the improved group were lower than those in the pre-improved group （P < 0.05）. The results of 4-week follow-up showed that the scores of NRS-2002 for nutritional risk screening in 2 groups were lower than before intervention （P < 0.05）， and the scores of NRS-2002 for nutritional risk screening in the improved group were significantly lower than those in the pre-improvement group （P < 0.05）. The comparison showed that the incidence of aspiration and aspiration pneumonia in the improved group was lower than that in the pre-improved group （P < 0.05）， and the satisfaction score of patients with the relevant preventive measures was higher than that in the pre-improved group （P < 0.05）. Conclusion The "ASK-T" aspiration prevention management model， when applied in the nursing of elderly patients with COPD complicated by dysphagia， can significantly reduce the risk of aspiration and the incidence of aspiration pneumonia， effectively improve patients' swallowing function and quality of life， and enhance their nutritional status. Furthermore， this model significantly improves patient satisfaction with intervention measures， providing a scientific and effective management strategy for clinical nursing of elderly patients with COPD complicated by dysphagia. It is worthy of promotion and application in clinical practice.

Key words: "ASK-T" aspiration prevention management model, chronic obstructive pulmonary disease （COPD）, elderly patients, dysphagia, aspiration risk

CLC Number:

R563.3

Wenfang HE,Xun ZHOU,Meizhu DING,Yiping CHEN,Qianli LIU,Xinyuan. TAN. Application of the "ASK⁃T" aspiration prevention management model in reducing the risk of aspiration in elderly patients with chronic obstructive pulmonary disease （COPD） complicated by dysphagia[J]. The Journal of Practical Medicine, 2025, 41(3): 434-441.

Figures/Tables 8

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References 26

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组别	性别（例）		年龄（x ± s）/岁	BMI（x ± s）/（kg/m²）	教育程度/例			误吸风险等级/例
组别	男	女	年龄（x ± s）/岁	BMI（x ± s）/（kg/m²）	小学及以下	初中/高中	本科及以上	低风险	中风险	高风险
改善前组（n = 102）	65	37	70.95 ± 6.49	19.96 ± 2.45	18	55	29	23	53	26
改善后组（n = 94）	66	28	69.73 ± 7.21	20.17 ± 2.31	17	49	28	17	45	32
t/χ²/Z值	0.929		1.268	0.616	0.066			1.850
P值	0.335		0.206	0.539	0.968			0.396

组别	误吸风险等级
组别	无误吸风险	低风险	中风险	高风险
改善前组（n = 102）	2（1.96）	25（24.51）	58（56.86）	17（16.67）
改善后组（n = 94）	15（15.96）	50（53.19）	21（22.34）	8（8.51）
χ²值	38.581
P值	< 0.001

组别	SSA评分
组别	干预前	干预后	t值	P值
改善前组（n = 102）	34.58 ± 5.12	31.23 ± 6.47	4.101	< 0.001
改善后组（n = 94）	35.61 ± 4.75	28.35 ± 5.35	9.839	< 0.001
t值	1.457	3.380
P值	0.147	0.001

组别	生活质量各维度评分						总评分
	心理障碍		营养与呼吸功能受限		误吸症状		总评分
	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
改善前组（n = 102）	21.96 ± 2.89	20.93 ± 2.85^*	27.81 ± 3.93	26.52 ± 2.96^*	25.16 ± 4.11	23.56 ± 3.13^*	74.53 ± 9.87	71.23 ± 9.13^*
改善后组（n = 94）	21.78 ± 2.93	19.85 ± 2.79^*	27.79 ± 4.32	25.12 ± 3.98^*	24.51 ± 3.63	22.32 ± 2.89^*	73.56 ± 9.52	67.95 ± 8.21^*
t值	0.433	2.677	0.034	2.809	1.170	2.874	0.699	2.637
P值	0.666	0.008	0.973	0.005	0.244	0.005	0.485	0.009

组别	误吸	吸入性肺炎
改善前组（n = 102）	23（22.55）	18（17.65）
改善后组（n = 94）	12（12.77）	7（7.45）
χ²值	4.956	4.574
P值	0.026	0.032

Application of the "ASK⁃T" aspiration prevention management model in reducing the risk of aspiration in elderly patients with chronic obstructive pulmonary disease （COPD） complicated by dysphagia

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组别	满意度评分
改善前组（n = 102）	90.83 ± 2.53
改善后组（n = 94）	94.16 ± 3.27
t值	8.008
P值	<0.001

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