冰盐水喷洒口腔黏膜缓解吞咽功能障碍患者口渴的效果分析

Effect of iced saline spraying oral mucosa in relieving thirst in patients with dysphagia

目的探讨冰盐水喷洒口腔黏膜缓解吞咽功能障碍患者口渴的应用效果。方法本研究为试验性研究,选取2020年11月至2021年8月内蒙古自治区人民医院神经内科重症监护室吞咽功能障碍的患者70例,采用随机数字表法分为对照组和冰盐水组各35例。对照组男性患者23例,女性患者12例,年龄(68.11±10.16)岁;冰盐水组男性患者19例,女性患者16例,年龄(67.69±13.54)岁。对照组采用神经内科常规护理,即无菌棉签蘸生理盐水湿润口唇及舌面,冰盐水组将2~6℃的冰盐水装入象鼻喷壶,直喷喷洒口腔黏膜。采用口渴主观评价指标和客观评价指标对患者口渴程度、口腔唾液pH值等进行评价和统计学分析,比较两种方法缓解患者的口渴程度,采用Spearman相关性分析分析口渴程度与口腔唾液pH值的相关性。计量资料采用独立样本t检验,计数资料采用χ^(2)检验,等级资料比较采用秩和检验。结果干预后,对照组口渴数字等级评分(NumericRatingScale,NRS)为(8.51±0.85)分,冰盐水组NRS为(1.26±1.12)分,差异有统计学意义(t=30.487,P<0.001);对照组口腔唾液pH值为(6.01±0.19),冰盐水组口腔唾液pH值为(6.94±0.24),差异有统计学意义(t=-17.890,P<0.001)。Spearman相关性分析显示NRS与口腔唾液pH值之间为负相关(rs<0,P<0.05)。结论冰盐水喷洒口腔黏膜可以缓解患者口渴的程度,患者的口渴程度与口腔唾液pH值之间呈中度负相关,口渴程度越严重,口腔唾液pH值越小,通过口腔唾液pH值可以判断患者口渴的严重程度。

Objective To explore the application effect of iced saline spraying oral mucosa in relieving thirst in patients with dysphagia.Methods This study was a pilot study.From November 2020 to August 2021,70 patients with dysphagia in the neurology intensive care unit of Inner Mongolia People's Hospital were admitted.According to the random number table,they were randomly divided into 35 cases in the treatment group and 35 cases in the control group.There were 23 males and 12 females in the control group,with an age of(68.11±10.16)years old;there were 19 males and 16 females in the treatment group,with an age of(67.69±13.54)years old.For the control group,we used sterile cotton swabs dipped in normal saline to moisten the lip and tongue every 4 hours for 5 consecutive days;for the treatment group,we put 2-6℃iced saline into an elephant nose watering pot and sprayed directly onto the oral mucosa.The thirsty subjective evaluation and objective evaluation indexes were used to evaluate patients'thirsty degree and oral saliva pH value.The two methods were compared in relieving patients'thirst.Spearman correlation analysis was used to analyze the correlation between the thirsty degree and oral saliva pH value.Independent sample t test was used for the measurement data,χ^(2) test was used for the count data,and rank sum test was used for the grade data.Results After intervention,the score of Numeric Rating Scale(NRS)was(8.51±0.85)in the control group and(1.26±1.12)in the treatment group,with a statistically significant difference(t=30.487,P<0.001);the pH value of oral saliva in the control group was(6.01±0.19),and that in the treatment group was(6.94±0.24),with a statistically significant difference(t=-17.890,P<0.001).Spearman correlation analysis showed that there was a negative correlation between the score of NRS and oral saliva pH value(rs<0,P<0.05).Conclusions Spraying the oral mucosa with iced saline can relieve the patients'thirst.There is a moderate negative correlation between the degree of thirst and the pH value of oral saliva.The more severe the thirst,the lower the oral saliva pH value.The severity of thirst can be judged by the pH value of oral saliva.