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一项多中心、前瞻性临床试验,评估了一种新型粘合底座(Provox StabiliBase)在喉切除术后肺部和语音康复设备的造口周围附着的效果。

A multicenter, prospective, clinical trial evaluating a novel adhesive baseplate (Provox StabiliBase) for peristomal attachment of postlaryngectomy pulmonary and voice rehabilitation devices.

机构信息

Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Nijmegen, the Netherlands.

出版信息

Laryngoscope. 2012 Nov;122(11):2447-53. doi: 10.1002/lary.23469. Epub 2012 Aug 2.

Abstract

OBJECTIVES/HYPOTHESIS: Assessment of a novel adhesive baseplate (Provox StabiliBase) for heat and moisture exchanger (HME) and/or automatic speaking valve (ASV) application.

STUDY DESIGN

Prospective, clinical, multicenter trial.

METHODS

This was a trial in laryngectomized patients comparing their usual adhesive with the trial adhesive. Primary outcome measure was overall patient preference; additional outcome parameters possibly explaining patients' preferences were 1) patient tolerance and preference with respect to daily handling of the adhesive; 2) adhesive lifespan, and 3) voice and speech with the adhesives. Study specific questionnaires, visual analog scales, patients' diaries, and stoma assessments were used for data collection.

RESULTS

In total, 58 of the 65 laryngectomized individuals entered in the study completed the trial. Patients' overall preference for the new device was high (76%; P < .001). Significantly better performance was found for the trial adhesive with respect to ease of application (P = .034), fit (P < .001), and air leakage through the adhesive (P < .001). Comfort and stoma depth correlated weakly (r = 0.297; P = .024; deeper stoma-more comfort with StabiliBase). The adhesive lifespan with HME is significantly increased (1.7 times and 15.7 hours-plus airtight use; P < .001). This longer lifespan coincided with somewhat increased dirtying of the adhesive (P = .02). There were no serious adverse events.

CONCLUSIONS

The StabiliBase adhesive for peristomal attachment of HMEs and/or ASVs was preferred by 76% of study participants and showed a promising prolonged lifespan. This new device further increases the options for stoma attachment in laryngectomized individuals, and subsequently the availability of optimal voice and pulmonary rehabilitation for a larger proportion of patients.

摘要

目的/假设:评估一种新型粘合基底(Provox StabiliBase)在热和湿气交换器(HME)和/或自动语音阀(ASV)中的应用。

研究设计

前瞻性、临床、多中心试验。

方法

这是一项针对喉切除患者的试验,比较了他们通常使用的粘合剂和试验用粘合剂。主要观察指标是患者的总体偏好;可能解释患者偏好的其他观察指标是 1)患者对粘合基底日常处理的耐受性和偏好;2)粘合基底的使用寿命;3)使用粘合剂后的声音和言语。研究采用特定问卷、视觉模拟量表、患者日记和造口评估来收集数据。

结果

在总共 65 名入组研究的喉切除患者中,有 58 名完成了试验。患者对新装置的总体偏好很高(76%;P <.001)。试验用粘合基底在应用便利性(P =.034)、贴合度(P <.001)和粘合基底处的空气泄漏(P <.001)方面表现明显更好。舒适度和造口深度呈弱相关(r = 0.297;P =.024;造口越深,StabiliBase 舒适度越高)。使用 HME 时,粘合基底的使用寿命显著延长(1.7 倍和 15.7 小时以上的密封使用;P <.001)。这一更长的使用寿命与粘合基底的略微污染有关(P =.02)。没有发生严重不良事件。

结论

用于造口周围固定 HME 和/或 ASV 的 StabiliBase 粘合剂受到 76%研究参与者的青睐,并显示出有前景的延长使用寿命。这种新装置进一步增加了喉切除患者造口固定的选择,从而为更大比例的患者提供了最佳的声音和肺部康复机会。

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