数字评分法测量建立口咽部区域敏感图的试验研究  

The establishment of sensitive map of oropharynx using numerical rating scale method

作　　者：张艾兴 凌晓梅 刘高望[1] 唐建军[1] 韩广源 欧阳钧[3] 汪红艳 肖攀[1] 卢薪 严笑 李睿 杨雪莹[7] 肖金仿[1] LING Xiao-mei;LIU Gao-wang;TANG Jian-jun;HAN Guang-yuan;OUYANG Jun;WANG Hong-yan;XIAO Pan;LU Xin;YAN Xiao;LI Rui;YANG Xue-ying;XIAO Jin-fang(Department of Anesthesiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong,China)

机构地区：[1]南方医科大学南方医院麻醉科,广东广州510515 [2]维力医疗器械股份有限公司,广东广州511400 [3]南方医科大学基础医学院,广东广州510515 [4]长江大学附属仙桃市第一人民医院心内科,湖北仙桃433000 [5]广西医科大学第二附属医院麻醉科,广西南宁530001 [6]广州市中西医结合医院麻醉科,广东广州510801 [7]中山大学孙逸仙纪念医院麻醉科,广东广州510120

出　　处：《广东医学》2019年第12期1667-1672,共6页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2016B090918111,2017B020235001)

摘　　要：目的通过数字评分法测量口咽部敏感性,建立口咽部区域敏感图,为设计提高患者耐受性的改良口咽通气道打下基础。方法受试者共92例。使用指夹式脉搏血氧仪记录初始心率,而后使用一根棉签轻触口腔内的33个点。33个点中,7个点分布于硬腭,6个点分布于软腭,4个点分布于颊部,16个点分布于舌部。各点以咽后壁为中心,螺旋向外扩散排列。轻触每一点后让受试者使用口咽部刺激反射敏感性评分表格评分。测试者记录在每一点停留的时间及心率,并观察询问受试者有无咳嗽、呕吐等症状和其他感受。结果在92例受试者中,评分最高者为点4即咽后壁中心点,平均评分在2.5分以上者为点1、2、3、4、5、6、7、10、11、12。其中,点1为悬雍垂处;点4为咽后壁中心处;点2、3、5、6、7分别分布于腭舌弓和软腭处;点10、11、12分布于舌根部。这10点的评分与其他点评分差异有统计学意义(P<0.05)。点10、11、12(舌根部)与点1、2、3、5、6、7(软腭区)评分上差异有统计学意义(P<0.05),点10、11、12均较点1~7评分高。点4与点10、11、12之间的评分差异无统计学意义(P>0.05)。左右相对应的各点(如2和6,3和5,10和12)评分之间差异无统计学意义(P>0.05)。耐受时间上,点4、10、11、12这4个点的平均值明显高于其余29个点(P<0.05)。结论口咽部中咽后壁为敏感性最高区域,其次为软腭区域。如在设计中避开或减少对两处区域的刺激,有可能提高患者对于口咽通气道的耐受性。Objective To examine the sensitivity of oropharynx by numerical rating scale method and establish a sensitive map of oropharynx. Methods Ninty-two subjects are eligible. The initial heart rate was recorded with a finger-clamp pulse oximeter. A cotton swab was used to gently touch 33 points in their mouths points, among which 7 points were distributed in the hard palate, 6 points were distributed in the soft palate, 4 points were distributed in the cheeks, and 16 points were distributed in the tongue. Each point was centered on the posterior pharyngeal wall and spirally spread outward. The Oropharynx Stimulate Reflection Sensitivity Score was applied to grade each point. The duration of swab touch at each point and reactive heart rate, special feelings or impulses towards coughing or vomiting were also inquired and documented. Results Among the 92 volunteers, the highest score was recorded at Point 4, which was located at the center of posterior pharynx. The scores higher than 2.5 were recorded at Point 1, 2, 3, 4, 5, 6, 7,10, 11 and 12, which were significantly differ with the other points(P<0.05). The scores of Points 10, 11 and 12 were significantly different with those of Point 1, 2, 3, 5, 6 and 7(P<0.05). The scores of Point 10, 11 and 12 were significantly higher than those of Point 1, 2, 3, 4, 5, 6 and 7(P<0.05). The tolerance durations of Point 4, 10, 11 and 12 were significantly longer than the other 29 points(P<0.05). Conclusion The posterior pharynx is the most sensitive area in the oropharynx, followed by the soft palate area. Avoidance or reduction in stimulus on these two areas will improve patient′s tolerance.

关 键 词：口咽部 刺激 敏感性 口咽通气道 

分 类 号：R856.78[医药卫生—航空、航天与航海医学] R614.1[医药卫生—临床医学]