说话瓣膜配合口腔感觉治疗脑外伤吞咽功能障碍的临床效果分析

Clinical Effect of Speech Valve Combined With Oral Sensation in the Treatment of Swallowing Dysfunction After Traumatic Brain Injury

目的针对说话瓣膜配合口腔感觉治疗脑外伤吞咽功能障碍的临床效果进行分析与评估。方法选取我院于2019年1—7月确诊收治的脑外伤并吞咽功能障碍患者60例为本研究观察对象,按照随机数字表法进行分组,对照组30例,观察组30例。对照组给予常规治疗,观察组在对照组治疗措施基础之上配合实施说话瓣膜治疗。对两组患者颚咽收缩压力峰值、食管上括约肌(upper esophageal sphincter,UES)松弛后压力峰值、以及渗漏误吸量表评分结果检出值进行对比观察。结果接受治疗前,两组患者颚咽收缩压力峰值、UES松弛后压力峰值、以及渗漏误吸量表评分结果检出值,比较差异无统计学意义(P>0.05);接受治疗后,观察组颚咽收缩压力峰值检出值(150.8±35.3)mmHg、UES松弛后压力峰值检出值(208.5±23.9)mmHg均显著高于对照组(P<0.05),渗漏误吸量表评分结果检出值(2.9±1.3)分,显著低于对照组,差异有统计学意义(P<0.05)。结论说话瓣膜配合口腔感觉治疗脑外伤吞咽功能障碍患者可以通过改善患者气管切开术后颚咽收缩功能以及UES松弛后收缩功能的方式,预防误吸症状的发生,值得临床进一步推广应用。

Objective To analyze and evaluate the clinical effect of speech valve combined with oral sensation in the treatment of swallowing dysfunction after traumatic brain injury.Methods A total of 60 patients with brain injury and swallowing dysfunction diagnosed and treated in our hospital from January to July 2019 were selected as the observation objects of this study,and they were divided into groups according to the method of digital random table,30 cases in the control group and 30 cases in the observation group.The patients in the control group were given conventional treatment,while the patients in the observation group were treated with speech valve therapy on the basis of treatment measures in the control group.The peak value of pharyngeal contraction pressure,ues relaxation pressure peak value and leakage aspiration scale score were compared between the two groups.Results Before treatment,there was no significant difference between the two groups(P>0.05);After treatment,the peak value of the maxillopharyngeal systolic pressure in the observation group was(150.8±35.3)mmHg,and that after ues relaxation was(208.5±23.9)mmHg It was significantly higher than that of the control group(P<0.05),and the detection value of the leakage aspiration scale score was(2.9±1.3)points,which was significantly lower than that of the control group(P<0.05).Conclusion The treatment of swallowing dysfunction after traumatic brain injury with speech valve combined with oral sensation can prevent aspiration symptoms by improving the jaw pharyngeal contraction function after tracheotomy and the contraction function after ues relaxation,which is worthy of further clinical application.