摘要
目的探讨声门下吸引染色测试法评估神经重症人工气道患者早期吞咽功能的可行性与安全性。方法选取2018年1月至2019年5月我院收治的100例神经重症人工气道患者为研究对象,随机等分为观察组与对照组。对照组实施染色吞咽功能测试法评测,观察组采取声门下吸引染色法评测。比较评测前及评测开始5 min后两组呼吸频次(RR)、血氧饱和度(SpO 2),比较评测后即刻及评测后24 h时两组外周血白细胞计数(WBC)、降钙素原(PCT)变化,辨别评测后24 h时两组胸部CT不良征象发生率,比较两组评测所需时间及住院期间及患者吸入性肺炎发生率。结果评测开始5 min后,观察组RR、SpO 2水平与评测前比较差异均无统计学意义(P>0.05),且RR水平明显低于对照组,SpO 2水平明显高于对照组(P<0.05)。评测后24 h时,观察组外周血WBC、PCT水平与评测后即刻比较差异均无统计学意义(P>0.05),且明显低于对照组(P<0.05);观察组胸部CT不良征象总发生率明显低于对照组(P<0.05)。观察组评测所需时间短于对照组(P<0.05),住院期间吸入性肺炎发生率明显低于对照组(P<0.05)。结论声门下吸引染色测试法应用于神经重症人工气道患者早期吞咽障碍评估兼具可行性与安全性,可有效简化护理操作,量化吞咽障碍程度,有利于尽早为吞咽功能训练或经口进食提供循证依据。
Objective To investigate the feasibility and safety of dyeing test under subglottic suction to evaluate early dysphagia in patients with artificial airways who underwent neurological intensive.Methods We selected 100 cases of patients with artificial airways who underwent neurological intensive care and admitted in our hospital from January 2018 to May 2019 as the study objects,and they were randomly divided into an observation group and a control group.The control group was evaluated by the dyeing and swallowing function test method,and the observation group was evaluated by the dyeing test method under subglottic suction.The respiratory frequency(RR)and blood oxygen saturation(SpO 2)of the two groups were compared before and 5 minutes after the start of the evaluation,the peripheral blood white blood cell count(WBC),changes of procalcitonin(PCT)of the two groups were compared immediately after the evaluation and at 24 hours after the evaluation to identify the incidence of adverse CT signs in the two groups at 24 h after evaluation,as well as compare the time required for evaluation between the two groups and the incidence of aspiration pneumonia during hospitalization.Results After 5 minutes from the start of the evaluation,the RR and SpO 2 levels in the observation group were not significantly different from those before the evaluation(P>0.05),and the RR levels were significantly lower than that of the control group,and the SpO 2 levels were significantly higher than that of the control group(P<0.05).At 24 hours after the evaluation,the levels of WBC and PCT in the peripheral blood of the observation group were not significantly different from those immediately after the evaluation(P>0.05),and were significantly lower than those in the control group(P<0.05).The total incidence of adverse CT signs in the observation group was significantly lower than that in the control group(P<0.05).The time required for evaluation in the observation group was shorter than that in the control group(P<0.05).The incidence of aspiration pneumonia during hospitalization in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The dyeing test method under subglottic suction was applicable to the assessment of early dysphagia in patients with artificial airways who underwent neurological intensive care..It had both feasibility and safety,could effectively simplify nursing operations,quantify the degree of dysphagia,and was conducive to early training of swallowing functions or provide evidence-based evidence for oral eating.
作者
卢媚媛
崔玉梅
莫小冠
LU Mei-yuan;CUI Yu-mei;MO Xiao-guan
出处
《护理实践与研究》
2020年第1期4-6,共3页
Nursing Practice and Research
基金
东莞市社会科技发展(一般)项目(2018507150101346)
关键词
声门下吸引
染色测试法
神经重症
早期评估
吞咽障碍
Subglottic suction
Dyeing test method
Neurological intensive
Early evaluation
Dysphagia
