目的   基于决策树构建老年患者吞咽障碍预警模型。方法  采用便利取样法对宁夏银川市宁夏回族自治区人民医院老年科住院的200例老年患者进行调查。结果  200例老年患者中，吞咽障碍发生率为40.5%。依据是否发生吞咽障碍将其患者分为两组，两组患者在性别、年龄、文化程度、职业、医保类型、家庭年收入、日常生活能力、衰弱、抑郁、营养、体质指数（BMI）比较（χ ² 值分别为13.321、4.064、31.944、36.695、18.230、19.681、52.509、10.253、20.456、9.070、9.483），差异均有统计学意义（均P＜0.05）。决策树模型筛选出老年患者吞咽障碍的影响因素主要有自理能力、职业、文化程度和抑郁，决策树模型受试者工作特征曲线下面积为0.862，灵敏度为79.8%，特异度为79.0%，P＜0.001。结论  基于自理能力、职业、文化程度和抑郁构建的决策树模型，能有效预测老年患者吞咽障碍风险。

       Objective  To construct a swallowing disorder warning model for elderly patients based on decision tree．Methods  Convenience  sampling was  used to  study  200  elderly  patients  admitted to the  geriatric  department  of  a tertiary comprehensive hospital in Yinchuan，Ningxia．Results  Among 200 elderly patients，the incidence of swallowing disorders was 40.5%．The two groups of patients were compared in terms of gender，age，education level，occupation，medical insurance type，annual family income，daily living ability，frailty，depression，nutrition，and BMI（χ ²  values were 13.321，4.064，31.944，36.695，18.230，19.681，52.509，10.253，20.456，9.070，9.483，respectively），and the  differences were  statistically significant（all P＜0.05）．The decision tree model identified the main influencing factors of swallowing disorders in elderly patients as self-care ability，occupation，education level，and depression．The Receiver Operating Characteristic curve of the decision tree model had an area under the curve of 0.862，sensitivity of 79.8%，and specificity of 79.0%，P＜0.001．Conclusions  A decision tree model based on self-care ability，occupation，education level，and depression can effectively predict the  risk of swallowing disorders in elderly patients．

吞咽障碍是慢性阻塞性肺疾病（COPD）的常见并发症之一,并且是COPD急性加重的危险因素之一,对患者预后造成不良影响。对COPD患者吞咽障碍的发生及严重程度进行准确的评估,是进行科学管理的首要前提。本文对COPD吞咽障碍评估工具的基本特点、应用现状及发展现状进行综述,为临床医务人员选择评估工具提供借鉴。

Dysphagia is one of the common complications of chronic obstructive pulmonary disease（COPD）,and is one of the risk factors of acute exacerbation of COPD,which has adverse effects on the prognosis of patients．Accurate assessment of the occurrence and severity of dysphagia in COPD patients is the first step for scientific management．In this paper,the basic characteristics,application status and development status of assessment tools for COPD patients with dysphagia are reviewed,which can provide reference for the selection of assessment tools for clinical medical staff．

目的 氧气雾化吸入体位对颈椎前路减压植骨融合术后吞咽困难的影响。方法 将在2017年2月—2019年10月期间行颈椎前路减压植骨融合术患者(2～3节段)123例随机分成两组:A组(n=56,半卧位行氧气雾化), B组(n=67,平卧位行氧气雾化)。比较两组术后吞咽困难发生及程度、持续时间情况和患者对氧气雾化吸入方法满意度。结果 A组术后吞咽困难发生率低于B组(P=0.042),并且吞咽困难程度动态变化中总体优于B组;两组吞咽困难持续时间无统计学差异(P=0.826)。A组患者对氧气雾化吸入方法满意度优于B组患者(P=0.022)。结论 半卧位氧气雾化吸入能降低颈椎前路术后吞咽困难的发生及严重程度。

Objective To investigate the effect of aerosol inhalation position on dysphagia after multi-segment anterior cervical decompression and bone graft fusion. Methods 123 patients undergoing anterior cervical decompression and bone graft fusion during February 2017 to October 2019 were randomly divided into two groups: group A (n=56, aerosol inhalation in semireclining position), group B (n=67, aerosol inhalation in the supine position). The incidence, extent and duration of dysphagia were compared between the two groups. Results The incidence of postoperative dysphagia in group A was lower than that in group B (P=0.042), and the degree of dysphagia were better than that in group B in the dynamic changes. There was no statistical difference in the duration of dysphagia between the two groups (P=0. 826). Patients in group A had greatly better satisfaction with the aerosol inhalation position than patients in group B (P=0.022). Conclusion Aerosol inhalation in semireclining position can reduce the incidence and severity of dysphagia after anterior cervical spine surgery.