韩晓晓,张可,杨清露,等.Passy-Muir说话瓣膜对脑损伤气管切开术后患者吞咽功能的影响[J].中华物理医学与康复杂志,2020,42(1):24-28
扫码阅读全文
|
| Passy-Muir说话瓣膜对脑损伤气管切开术后患者吞咽功能的影响 |
|
| |
| DOI：DOI:10.3760/cma.j.issn.0254-1424.2020.01.006 |
| 中文关键词: 气管切开术 误吸 Passy-Muir说话瓣膜 吞咽功能 |
| 英文关键词: Tracheotomy Aspiration Passy-Muir speaking valve Swallowing |
| 基金项目:国家自然科学基金面上项目（81472153） |
|
| 摘要点击次数: 4736 |
| 全文下载次数: 5757 |
| 中文摘要: |
| 目的 探讨Passy-Muir说话瓣膜（PMV）对脑损伤气管切开术后患者吞咽生物力学和误吸的影响。 方法 选取符合纳入标准的脑损伤气管切开术后伴误吸的患者20例，按随机数字表法分为非PMV干预组（10例）和PMV干预组（10例）。非PMV干预组给予常规吞咽康复训练，PMV干预组在此基础上给予佩戴PMV治疗，治疗结束时间为治疗2周后或拔除气管套管时。分别于治疗前和治疗结束后（治疗后），采用高分辨率测压检查和吞咽造影检查评估2组患者吞咽过程中的颚咽收缩压力峰值（VP-Max）、食管上括约肌松弛后压力峰值（UES-Max）及渗漏-误吸（PAS）评分。 结果 治疗前，2组患者的VP-Max、UES-Max及PAS评分组间比较，差异均无统计学意义（P>0.05）。治疗后，2组患者的VP-Max和UES-Max较组内治疗前均有明显改善（P<0.05）；PMV干预组的PAS评分亦较组内训练前明显改善（P<0.05）。治疗2周后，PMV干预组的VP-Max和UES-Max分别为(150.87±65.51)mmHg和(206.00±42.28)mmHg，明显高于非PMV干预组(122.45±74.45)mmHg和(190.17±79.56)mmHg，差异有统计学意义（P<0.05）。且VP-Max的增高与PAS评分的改善之间呈正相关（P<0.05）。 结论 PMV干预能够改善脑损伤气管切开术后患者腭咽收缩功能和UES松弛后收缩功能，腭咽收缩压力峰值的增高与误吸情况的改善呈正相关。 |
| 英文摘要: |
| Objective To investigate the effect of a Passy-Muir speaking valve (PMV) on the biomechanics of swallowing and on aspiration among persons tracheotomized after brain damage. Methods Twenty tracheotomized patients with aspiration after brain injury were selected and randomly divided into a non-PMV intervention group and a PMV intervention group, each of 10. Both groups were given routine swallowing training, while the PMV intervention group was additionally provided with a PMV and trained to use it. The treatment ended when the tracheal tube was removed or after 2 weeks. High-resolution manometry and videofluoroscopy were used to evaluate the maximum pressure in the velopharynx (VP-Max), the maximum post-deglutitive upper esophageal sphincter (UES) pressure (UES-Max) and Rosenbek penetration aspiration (PAS) scores for both groups before and after the treatment. Results Before the treatment there was no significant difference between the two groups in terms of average VP-Max, UES-Max or PAS score. After the treatment, the average VP-Max and UES-Max had increased significantly in both groups, and the average PAS score of the PMV intervention group had decreased significantly. There was a significant positive correlation between the increases in VP-Max and the decrease in PAS scores. Conclusion Inserting a PMV can improve velopharynx contraction and post-deglutitive UES among persons tracheotomized after a brain injury. The increase in maximum velopharynx pressure is positively correlated with decreases in aspiration. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
