佩戴说话瓣膜对吞咽障碍患者渗漏和误吸影响的研究

Effect of dysphagia ventilation swallowing and speaking valve on penetration and aspiration in patients with swallowing disorder

目的:探讨气管切开患者治疗方法,分析说话瓣膜对气管切开吞咽障碍患者渗漏、误吸的影响。方法:收集气管切开、病程较长、未能拔除气管套管的伴吞咽障碍患者,在其气管套管口配戴说话瓣膜,采用吞咽造影检查观察配戴时与未配戴说话瓣膜时渗漏、误吸程度的变化,应用Rosenbek误吸程度分级对其分析,对照使用前后渗漏和误吸发生率。结果:气管切开患者在配戴说话瓣膜时与未配戴时进行吞咽造影检查发现,患者中配戴说话瓣膜者与未配戴者级别有变化;佩戴说话瓣膜时降低了误吸发生率。结论:患者佩戴说话瓣膜时误吸程度逐渐向渗漏程度改善,患者自身的渗漏、误吸程度减轻,降低了误吸发生率。

Objective：To analyze the effects of swallowing and speaking valve on penetration and aspiration in patients with swallowing disorder after tracheostomy.Methods：Swallowingspeaking valves（Passy-Muir,USA,PMVs） were applied to 32 patients with swallowing disorder after tracheostomy for long time.After 1 week,VFSS was taken to show the difference of penetration and aspiration between with and without PMVs.The incidence of penetration and aspiration was analyzed by Rosenbek Penetration Scale.Result：VFSS proved that none of Rosenbek was observed in both conditions of patients with and without PMVs,6 patients were observed to have the same level in both conditions and 26 patients were different The incidence of aspiration was 81.23% in patients without PMVs and 56.25% in those with PMVs.The application of PMVs was helpful to decrease the incidence of aspiration.Conclusion：The application of PMVs is helpful to decrease the risk of penetration and aspiration and reduce the incidence of aspiration.