染色增稠剂测试在颈髓损伤气管切开管饲患者试拔管中的应用

Role of staining thickener test in extubation for cervical spinal cord injury patients with tube feeding after tracheotomy

目的探讨染色增稠剂测试在颈髓损伤后气管切开管饲患者试拔管中的应用效果。方法选取2018年1月至2019年12月入住康复科的颈髓损伤气管切开并留置胃管患者共85例,按照入科时间先后顺序分组,其中对照组40例,试验组45例。对照组患者采用传统直接试进食方法进行指导,试验组采用将液体果绿染色并用增稠剂增稠至3种特定稠度进行定量吞咽功能评估。比较两组患者误吸发生情况及鼻饲管留置时间。结果试验组患者误吸发生率较对照组降低,胃管留置时间明显比对照组短,两组比较,差异具有统计学意义(均P<0.05)。结论染色增稠剂测试能较准确评估颈髓损伤气管切开并留置胃管患者的吞咽功能情况,提高患者摄食安全性,降低误吸发生率,缩短胃管留置时间。

Objective To investigate the effect of staining thickener test in extubation for cervical spinal cord injury patients with tube feeding after tracheotomy. Methods A total of 85 patients with cervical spinal cord injury who underwent tracheotomy and intubation of gastric tube in the department of TCM rehabilitation from January 1,2018 to December 31,2019 were divided into the control group(n=40) and the observation group(n=45) according to their admission sequence. The control group was managed with the routine direct nasal feeding and the observation group was fed with liquids stained in fruit green and thickened with thickeners to three specific thicknesses for quantitative swallowing function evaluation. The incidence of aspiration and the retention time of nasal feeding tube were compared between the two groups. Results The incidence of aspiration in the observation group was significantly lower(P<0.05),and the retention time of gastric tube was significantly shorter than that in the control group(P<0.05). Conclusions Staining thickener test can accurately evaluate the swallowing function of patients with cervical spinal cord injury,tracheotomy and indwelling gastric tube,improve the safety of feeding,shorten the indwelling time of gastric tube and reduce the incidence of aspiration.