Marik Paul E, Kaplan Danielle
Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Chest. 2003 Jul;124(1):328-36. doi: 10.1378/chest.124.1.328.
Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in the elderly, and the leading cause of death among residents of nursing homes. Oropharyngeal aspiration is an important etiologic factor leading to pneumonia in the elderly. The incidence of cerebrovascular and degenerative neurologic diseases increase with aging, and these disorders are associated with dysphagia and an impaired cough reflex with the increased likelihood of oropharyngeal aspiration. Elderly patients with clinical signs suggestive of dysphagia and/or who have CAP should be referred for a swallow evaluation. Patients with dysphagia require a multidisciplinary approach to swallowing management. This may include swallow therapy, dietary modification, aggressive oral care, and consideration for treatment with an angiotensin-converting enzyme inhibitor.
社区获得性肺炎（CAP）是老年人发病和死亡的主要原因，也是养老院居民的主要死因。口咽误吸是导致老年人肺炎的一个重要病因。脑血管疾病和退行性神经系统疾病的发病率随年龄增长而增加，这些疾病与吞咽困难以及咳嗽反射受损有关，从而增加了口咽误吸的可能性。有吞咽困难临床体征和/或患有CAP的老年患者应转诊进行吞咽评估。吞咽困难患者需要多学科方法来进行吞咽管理。这可能包括吞咽治疗、饮食调整、积极的口腔护理以及考虑使用血管紧张素转换酶抑制剂进行治疗。
