The Clinical Studies Of Bedside Water-swallowing Ability Test And Bronchoscopy On Prevention And Diagnosis Elderly Aspiration Pneumonia

ObjectiveWith the acceleration of the aging process in china,the occurrence anddevelopment of the elderly aspiration pneumonia is gradually to be takenseriously. However,due to the lack of a unified "gold standard",the diagnosis ofaspiration pneumonia is still limited to the observation of clinical symptoms andsigns.Bedside water-swallowing ability test is simple,convenient and welltolerance,This paper discussed the methods of operation and indicators ofbedside water-swallowing ability test,and combined with fiberopticbronchoscopy to assess the correctness of the prevention and diagnosis ofpatients with aspiration pneumonia.Methods46patients with aspiration pneumonia (AP),30patients withcommunity-acquired pneumonia (CAP) and21patients with chronicobstructive pulmonary disease(COPD) were selected for this study..All thepatients of three groups were in stable condition,conscious state,undertake thebedside water-swallowing ability test by the same doctors, the time spending ondrinking up water, swallowing process and abnormal phenomenon occurredduring drinking was recorded, the data from about them was made into analysisand statistical. After two hours of fasting,Fiberoptic bronchoscopy was took onpatients with aspiration pneumonia when the consents were made withthem.The FEES scores were calculated, and the vomiting reflex and glotticsituation were observed. ResultsFor three groups of patients,there were not to show statistically significantdifferences among the age distribution (p=0.17) and the CURB-65score(p=0.42).There were significant differences in the time spending to drink up thesame volume wateramong the groups of patients(p<0.01), In the patients of APgroup, there appeared also to increase significantly interrupting and/or chokingand the frequency of abnormal swallowing phenomenon.42AP patients of theAP patients group who agreed with fiberoptic bronchoscopy were examined withfiberoptic bronchoscopy,6cases (14.29%) scored≤4points,the mean was3.00±0.63,36cases scored＞4points.When AP patients drank up10ml waterspent more than5seconds as a standard,the result of bedsidewater-swallowing ability test and fiberoptic bronhoscopy carried out was nosignificant differences(p＞0.1).ConclusionsBedside water-swallowing ability test cauld not only used to assist in thediagnosis of patients with aspiration pneumonia,also cauld guide theclassification of the disease for prevention and treatment,and had a well clinicalvalue.Assisted with the fiberoptic bronhoscopy can increase the reliablity of thediagnosis for AP.