气管切开套管对重症患者吞咽功能的影响  

Effects of tracheostomy tube on swallowing function in critically ill patients

作　　者：张中凯 卓飞男 仇鹏 周成业[1] 潘景业[1] ZHANG Zhongkai;ZHUO Feinan;QIU Peng(Department of Rehabilitation Medicine,Affiliated First Hospital,Wenzhou Medical University,Wenzhou325000,CHINA)

机构地区：[1]温州医科大学附属第一医院康复医学科,浙江325000

出　　处：《江苏医药》2024年第4期388-391,共4页Jiangsu Medical Journal

基　　金：浙江省科技厅“尖兵”“领雁”研发重大攻关项目(2023-C03084);温州市科技局基础性科研项目(Y2020534、Y2020023)。

摘　　要：目的观察气管切开套管对重症患者吞咽功能的影响。方法对40例行气管切开术的重症患者分别于气管切开套管拔管前48h和拔管5d后进行床旁吞咽功能评估[Gugging吞咽功能评估量表(GUSS)和功能性经口摄食量表(FOIS)]以及吞咽肌电检测(颏下肌群和舌骨上肌群表面肌电图检测)。结果与拔管前比较,拔管后患者GUSS评分增加,FOIS分级提高(P<0.01),吞咽时颏下肌群和舌骨上肌群肌电振幅增加,肌电活动时间减少(P<0.05)。结论气管切开套管会影响重症患者吞咽功能的安全性,并且会阻碍吞咽时喉上抬相关肌肉的活动。Objective To observe the impact of tracheostomy tube on the swallowing function in critically ill patients.Methods Bedside swallowing evaluation[Gugging swallowing screen(GUSS)and functional oral intake scale(FOIS)]of 40critically ill patients underwent tracheostomy was performed at the times of 48hours before and 5days after tracheostomy tube removal.Swallowing muscle surface electromyography(EMG)such as submental and suprahyoid muscle groups during swallowing was performed as well.Results Compared with before tracheostomy tube removal,the GUSS score and FOIS grading of the patients were increased(P<0.01),the EMG amplitude of the submental and suprahyoid muscle groups were increased and the duration of their EMG activity was decreased during swallowing after tracheostomy tube removal(P<0.05).Conclusion The presence of tracheostomy tube can affect the safety of swallowing function in critically ill patients and impede the activity of the muscles involved in hyolaryngeal elevation during swallowing.

关 键 词：气管切开套管 吞咽功能 肌电检测 

分 类 号：R493[医药卫生—康复医学]