Leder S B
Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut 06504, USA.
Dysphagia. 1999 Spring;14(2):73-7. doi: 10.1007/PL00009590.
The purpose of the present study was to investigate the incidence of aspiration in previously aspirating patients with tracheotomy after use of a one-way tracheotomy tube speaking valve. Twenty consecutive inpatients from the acute care setting of a large urban tertiary care teaching hospital were included. All subjects had objective documentation of aspiration by a fiberoptic endoscopic evaluation of swallowing prior to placement of a one-way tracheotomy speaking valve, from 2 to 7 days of valve use with intelligible speech production, and no surgery to the upper aerodigestive tract except tracheotomy. Results indicated that incidence of aspiration was not affected by use of a one-way tracheotomy speaking valve. These results are in agreement with previous observations that subjects either aspirated or swallowed successfully regardless of tracheotomy tube occlusion status. Also, no significant differences were found between aspiration status and time since tracheotomy, time off ventilator, or duration of valve use. It was concluded that use of a one-way speaking valve provided mostly nondeglutitive benefits and should not be considered to promote successful swallowing for patients with tracheotomy in the acute care setting.
本研究的目的是调查使用单向气管切开造口管发声阀后，既往有气管切开造口且存在误吸的患者的误吸发生率。纳入了一家大型城市三级护理教学医院急性护理病房的20例连续住院患者。所有受试者在放置单向气管切开造口发声阀之前，均通过纤维内镜吞咽评估有客观的误吸记录，在使用发声阀2至7天且能清晰发声，并且除气管切开造口外，上呼吸道消化道未进行其他手术。结果表明，单向气管切开造口发声阀的使用并未影响误吸发生率。这些结果与之前的观察结果一致，即无论气管切开造口管的阻塞状态如何，受试者要么成功误吸，要么成功吞咽。此外，在误吸状态与气管切开造口后的时间、脱机时间或发声阀使用时长之间未发现显著差异。得出的结论是，使用单向发声阀主要带来的是非吞咽方面的益处，在急性护理环境中，不应认为其能促进气管切开造口患者成功吞咽。
