可微调气管套管封堵器结合康复治疗对重症气管切开患者呼吸及言语功能的疗效观察

Effects of adjustable tracheal tube occluder combined with rehabilitation therapy on respiratory and speech function of patients with severe tracheotomy

目的:观察一种新式气管套管封堵用具——可微调气管套管封堵器,联合康复训练对重症气管切开患者呼吸及言语功能的应用效果。方法:共观察30例重症医学科康复治疗患者,按随机数字表分为试验组和对照组各15例。两组患者均接受重症临床和康复治疗,包括肺康复、吞咽与发声训练及运动疗法等,试验组患者在康复治疗期间佩戴可微调气管套管封堵器。两组患者的康复治疗时间均为每日2次,连续2周。治疗2周后,采用临床肺部感染评分(clinical pulmonary infection score,CPIS)、半定量咳嗽强度评分(semi-quantitative cough strength score,SCSS)、最长发声时间(maximum phonation time,MPT)与音量和气管套管拔管率等观察指标对两组患者进行比较。结果:经治疗两组患者的CPIS评分、SCSS评分、MPT与最高音量值均有明显变化(P<0.001)。其中,试验组患者SCSS得分同对照组比有显著性差异(P<0.05)。试验组MPT与最高音量值均高于对照组(P<0.05)。试验组患者气管套管拔管率高于对照组。结论:可微调气管套管封堵器联合康复治疗安全有效,对于改善重症气管切开患者呼吸及言语功能有积极意义。

Objective:To observe the effect of a new type of endotracheal tube occluder,which can be finely tuned,combined with rehabilitation training on respiratory and speech function of patients with severe tracheotomy.Method:A total of 30 patients with severe tracheotomy were randomly divided into test group and control group,15 cases in each group of patients received severe clinical and rehabilitation treatment,including lung rehabilitation,swallowing and phonation training and exercise therapy.Patients in the test group wore adjustable tracheal tube occluder during rehabilitation period.The rehabilitation treatment time of the two groups was twice a day for two consecutive weeks.After 2 weeks of treatment,clinical pulmonary infection score(CPIS),semi quantitative cough strength score(SCSS),maximum phonation time(MPT),volume and tracheal tube extubation rate were compared between the two groups.Result:After treatment,the CPIs score,SCSS score,MPT and maximum volume value of the two groups were significantly improved in both groups(P<0.001).The SCSS score of the test group improved more than that of the control group(P<0.05).The MPT and maximum volume of the test group were higher than those of the control group(P<0.05).The extubation rate of the test group was higher than that of the control group.Conclusion:The adjustable tracheal tube occluder is safe and effective,and combining with rehabilitation therapy,has positive significance for improving the respiratory and speech function of patients with severe tracheotomy.