果绿染色试验在评价脑卒中后气管切开并吞咽障碍患者渗漏和误吸的临床应用价值

The clinical application value of fruit green staining test in the evaluation of leakage and aspiration in the patients undergoing tracheotomy and dysphagia after stroke

目的探讨果绿染色试验在评价脑卒中后气管切开并吞咽障碍患者渗漏和误吸的临床应用价值。方法选择2018年1月至2019年6月在浙江省台州医院及温州医科大学附属第二医院住院治疗的脑卒中气管切开后长期不能拔出套管伴吞咽障碍的患者46例,分别完成果绿染色试验和咽动态造影检查,比较两种检查之间误吸检出率的差别,同时观察进食不同剂量和形状的食物后误吸发生的情况。结果果绿染色试验与咽动态造影检查轻度渗透、重度渗透及误吸发生率,差异无统计学意义(P>0.05),在发生渗漏误吸患者中,随着食物黏稠度的增高误吸的发生率也相应增高,且吞咽10 mL食量的误吸率较3 mL量增高,差异有统计学意义(P<0.05)。结论果绿染色试验可早期发现脑卒中后气管切开并吞咽障碍患者隐匿性误吸,有效提高误吸的检出率,该方法客观、简便、有效,糊状物及减小一口量可帮助患者减少误吸的发生。

Objective To explore the clinical application value of fruit green staining test in the evaluation of leakage and aspiration in the patients undergoing tracheotomy and dysphagia after stroke.Methods From January 2018 to June 2019,46 patients with stroke who underwent difficulty in being unable to pull out the cannula and dysphagia after tracheotomy were selected.They were hospitalized in Taizhou Hospital of Zhejiang Province and the Second Affiliated Hospital of Wenzhou Medical University.Fruit green staining test and pharyngeal dynamic contrast test were carried out respectively.The difference in aspiration detection rate was compared between the two tests.At the same time,the occurrence of aspiration after eating different doses and shapes of food was observed.Results There was no statistically significant difference between the fruit green staining test and the pharyngeal dynamic contrast test in the incidence of mild leakage,severe leakage and aspiration(P>0.05).In the patients with leakage and aspiration,the incidence of aspiration increases as the viscosity of food increases.The aspiration rate of swallowing 10 mL of food was higher than that of 3 mL,and the difference was statistically significant(P<0.05).Conclusion The fruit green staining test can detect occult aspiration in the patients undergoing tracheotomy and dysphagia after stroke,and effectively improve the detection rate of aspiration.The method is objective,simple,and effective.The batter-like diet and the reduction of a mouthful amount can help patients reduce the occurrence of aspiration.