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

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

目的探讨气管单向阀联合神经肌肉电刺激改善脑出血气管切开术后吞咽障碍患者误吸的临床疗效。方法2018年1月至12月,本院脑出血气管切开术后吞咽障碍患者37例,随机分为对照组(n=21)和综合组(n=16)。两组均接受神经肌肉电刺激,综合组佩戴气管单向阀进行训练,共3周。治疗前后,采用功能性经口摄食量表(FOIS)和渗漏-误吸量表(PAS)进行评定。结果治疗后,两组FOIS和PAS评分均显著改善(|Z|>3.544,P<0.001),综合组优于对照组(|Z|>2.094,P<0.05)。结论在神经肌肉电刺激的基础上联合气管单向阀训练可进一步改善脑出血气管切开术后吞咽障碍患者的误吸。

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.