说话瓣膜在颈脊髓损伤气管切开患者拔管中的应用  

The application of speaking valves in decannulation after a tracheostomy among patients with a cervical spi-nal cord injury

作　　者：文辉[1] 韩小彤[1] 刘智群[1] 高敏 刘晓华 毛淑贞 袁霞[1] Wen Hui;Han Xiaotong;Liu Zhiqun;Gao Min;Liu Xiaohua;Mao Shuzhen;Yuan Xia(Department of Emergency Medicine,Clinical Research Center For Emergency and Critical Care In Hunan Province,Hunan Provincial Institute of Emergency Medicine,Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics,Hunan Provincial People′s Hospital,The First Affiliated Hospital of Hunan Normal University,Chang-sha 410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)急诊医学科,湖南省急危重症临床医学研究中心,湖南省急救医学研究所,急危重症代谢组学湖南省重点实验室,长沙410005

出　　处：《中华物理医学与康复杂志》2024年第4期308-311,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：湖南省卫生健康委员会一般资助课题(202114011336)。

摘　　要：目的探讨说话瓣膜在颈脊髓损伤气管切开患者拔管中的应用效果。方法回顾性分析48例颈脊髓损伤气管切开患者的临床资料,根据患者是否使用说话瓣膜,分为常规组和说话瓣膜组,每组24例。比较2组患者的气切带管天数、气切至尝试堵管天数、出院时堵管及拔管情况。记录说话瓣膜组患者首次使用说话瓣膜的耐受时间、首次佩戴的发声情况、使用天数。对说话瓣膜组患者佩戴说话瓣膜前、后的半定量咳嗽强度评分(SCSS)进行比较。结果与常规组比较,说话瓣膜组患者的气切带管时间[(14.25±3.18)d]短,出院时未成功堵管的人数(3人)少(P<0.05)。说话瓣膜组19例(79.17%)患者首次使用说话瓣膜即可正常发声交流,佩戴说话瓣膜后SCSS[(4.14±0.35)分]增加(P<0.05)。结论颈脊髓损伤气管切开患者使用说话瓣膜可缩短气切带管时间,提高出院堵管率.Objective To explore the effect of using a speaking valve in decannulation of tracheostomy pa-tients with a cervical spinal cord injury(CSCI).Methods The records of 48 CSCI patients who had received a tra-cheostomy were analyzed retrospectively.Those using a speaking valve formed the speaking valve group(n=24),while the rest made up the conventional group.The duration of tracheostomy tube dependency,the interval between the tracheostomy and capping attempts,the rate of tracheostomy capping and the rate of decannulation at discharge were compared between the two groups.In the speaking valve group the tolerance for using a speaking valve for the first time was tabulated,as well as vocalization at the first use,and the number of days of use.Their cough strength scores(SCSSs)before and after using the speaking valve were also compared.Results Compared with the conven-tional group,the average duration of tracheostomy was shorter[(14.25±3.18)d]in the speaking valve group,and significantly fewer of the patients were without tube-capping at discharge(3 cases).Nineteen cases(79%)in the speaking valve group could communicate orally immediately at their first use of a speaking valve,and their average cough strength score increased significantly after using the speaking valve.Conclusion Using a speaking valve can shorten the duration of tracheostomy tube dependency and improve the rate of decannulation at discharge among cervi-cal spinal cord injury patients undergoing tracheostomy.

关 键 词：说话瓣膜 颈脊髓损伤 气管切开 

分 类 号：R651.2[医药卫生—外科学]