不同浓度辣椒素雾化液在意识障碍气管切开患者中的应用效果

Effects of different concentrations of capsaicin solution for nebulization in patients with disorders of consciousness undergoing tracheotomy

目的探讨不同浓度(31.2、62.5、125.0μmol/L)辣椒素雾化液在意识障碍(DoC)气管切开患者中的应用效果。方法选取2023年1月至2024年3月广东省工伤康复医院颅脑损伤康复科收治的90例DoC气管切开患者为研究对象,采用随机数表法分成三组,低浓度组30例、中浓度组30例及高浓度组30例,低浓度组予以31.2μmol/L、中浓度组予以62.5μmol/L、高浓度组予以125.0μmol/L的辣椒素雾化液通过8 L/min的高流量氧驱动雾化使患者持续地吸入。结果干预后,中浓度组、高浓度组咳嗽反射敏感性视觉模拟评分法(VAS)、昏迷恢复量表(修订版)(CRS-R)评分均高于低浓度组,差异有统计学意义(P<0.05);高浓度组咳嗽反射敏感性VAS评分、CRS-R评分均高于中浓度组,差异有统计学意义(P<0.05);高浓度组吞咽功能改善率高于中浓度组,差异有统计学意义(P<0.05);雾化时,三组生命体征均在可控范围内,未见严重不良反应。结论适宜的辣椒素浓度雾化吸入可有效提高意识障碍气管切开患者咳嗽反射敏感性,改善患者吞咽功能与意识状况,其中高浓度(125.0μmol/L)较低(31.2μmol/L)、中(62.5μmol/L)浓度辣椒素液效果更理想,并具有一定安全性。

Objective To investigate the effects of different concentrations(31.2,62.5,and 125.0μmol/L)of capsaicin solution for nebulization in patients with disorders of consciousness(DoC)undergoing tracheotomy.Methods A total of 90 patients with DoC undergoing tracheotomy admitted to the Department of Craniocerebral Injury Rehabilitation of Guangdong Work Injury Rehabilitation Hospital from January 2023 to March 2024 were selected for the study,and were divided into three groups using random number table,with 30 patients in the low concentration group,30 patients in the medium concentration group and 30 patients in the high concentration group.Capsaicin solution for nebulization was administered to patients in the low concentration group(31.2μmol/L),medium concentration group(62.5μmol/L)and high concentration group(125.0μmol/L)through continuous inhalation by high-flow oxygen-driven nebulization at 8 L/min.Results After the intervention,the visual analogue scale(VAS)for cough reflex sensitivity and coma recovery scale-revision(CRS-R)scores were higher in the medium concentration group and high concentration group than those in the low concentration group,with statistically significant differences(P<0.05).The cough reflex sensitivity VAS and CRS-R scores were higher in the high concentration group than those in the medium concentration group,with statistically significant differences(P<0.05).The improvement rate of swallowing function was higher in the high concentration group than that in the medium concentration group,with a statistically significant difference(P<0.05).At the time of nebulization,vital signs in all three groups were within manageable limits with no serious adverse reaction observed.Conclusion Nebulized inhalation of appropriate capsaicin concentration can effectively improve the cough reflex sensitivity in patients with DoC undergoing tracheotomy,and improve patients’swallowing function and consciousness status.The effect of high concentration(125.0μmol/L)of capsaicin solution is more ideal than that of low(31.2μmol/L)and medium(62.5μmol/L)concentrations,with a certain degree of safety.