应用气管单向阀对脑出血气管切开术后吞咽障碍患者误吸的疗效

doi:10.3969/j.issn.1006-9771.2020.11.008

Abstract

Abstract:

Objective To investigate the effects of a one-way tracheostomy speaking valve based on neuromuscular electrical stimulation on aspiration in patients with dysphagia after tracheotomy for cerebral hemorrhage.Methods From January to December, 2018, 37 patients with dysphagia after tracheotomy for cerebral hemorrhage were randomly divided into control group (n = 21) and experimental group (n = 16). Both groups accepted neuromuscular electrical stimulation, while the experimental group was trained to use one-way tracheostomy speaking valve additionally, for three weeks. They were assessed with Functional Oral Food Intake Scale (FOIS) and Penetration-Aspiration Scale (PAS) before and after treatment. Results The scores of FOIS and PAS improved in both groups after treatment (|Z| > 3.544, P < 0.001), and was better in the experimental group than in the control group (| Z| > 2.094, P < 0.05). Conclusion One-way tracheostomy speaking valve training based on neuromuscular electrical stimulation could improve swallowing and reduce aspiration of patients with dysphagia after tracheotomy.

Key words: cerebral hemorrhage, tracheotomy, dysphagia, one-way tracheostomy speaking valve, aspiration

CLC Number:

R743.34

ZHOU Hui-chang,ZHANG Pan-de,WEI Xiao-mei,DOU Zu-lin. Effect of One-way Tracheostomy Speaking Valve on Aspiration of Dysphagia Patients after Tracheotomy for Cerebral Hemorrhage[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(11): 1292-1296.

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References 27

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组别	n	性别(n)		年龄(岁)	病程(d)	GCS	MMSE
组别	n	男	女	年龄(岁)	病程(d)	GCS	MMSE
对照组	21	13	8	57.905±11.405	15.429±2.521	12.762±0.831	17.429±4.812
综合组	16	12	4	53.813±12.172	15.375±2.363	12.813±0.750	17.000±4.147
χ²/t值		0.711		1.050	0.066	-0.191	0.285
P值		0.491		0.301	0.948	0.849	0.778

组别	n	破入脑室		基底节区		大脑皮质
组别	n	左侧	右侧	左侧	右侧	左侧	右侧
对照组	21	4	1	2	3	6	5
综合组	16	2	2	2	2	3	5
χ²值		0.900		0.090		0.540
P值		0.343		0.764		0.463

次数	佩戴时长	时间	呼吸急促 (有/无)	口唇紫绀 (有/无)	甲床颜色 (红润/苍白)	呼吸频率 (次/min)	心率 (次/min)	血氧饱和度
1	1 min
2	5 min
3	10 min
4	15 min
5	30 min
6	1 h
7	2 h
8	3 h
9	4 h
10	5 h
11	6 h
12	12 h
13	24 h
.	24 h

组别	n	治疗前							治疗后							Z值	P值
组别	n	1级	2级	3级	4级	5级	6级	7级	1级	2级	3级	4级	5级	6级	7级	Z值	P值
对照组	21	10	10	1	0	0	0	0	0	0	3	4	3	10	1	-4.062	< 0.001
综合组	16	9	6	1	0	0	0	0	0	0	1	3	1	3	8	-3.592	< 0.001
Z值		-0.433							-2.094
P值		0.705							0.044

组别	n	治疗前								治疗后								Z值	P值
组别	n	1级	2级	3级	4级	5级	6级	7级	8级	1级	2级	3级	4级	5级	6级	7级	8级	Z值	P值
对照组	21	0	0	0	8	4	2	4	3	2	11	6	2	0	0	0	0	-4.045	< 0.001
综合组	16	0	0	0	5	4	1	3	3	8	6	2	0	0	0	0	0	-3.544	< 0.001
Z值		-0.364								-2.722
P值		0.728								0.010

Effect of One-way Tracheostomy Speaking Valve on Aspiration of Dysphagia Patients after Tracheotomy for Cerebral Hemorrhage

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