Park Yeo Jin, Lee Jesang, Kim Sang Hun, Ko Sung Hwa, Shin Myung Jun, Chang Jae Hyeok, Shin Yong Beom
Department of Rehabilitation Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Ann Rehabil Med. 2015 Dec;39(6):964-70. doi: 10.5535/arm.2015.39.6.964. Epub 2015 Dec 29.
To evaluate the care status of the amyotrophic lateral sclerosis (ALS) patients with long-term use of tracheostomy tube by caregivers of ALS patients.
A survey was conducted in the form of questionnaires to ALS patients and their caregivers. All measurements were performed by two visiting nurses. For statistical analysis, SPSS ver. 22.0 and Mann-Whitney U test on non-normal distribution were used.
In total, 19 patients (15 males and 4 females) and their caregivers participated in the survey. In the case of patients, the average duration of care was 5.9±3.7 years, and the mean periods of illness and tracheostomy were 5.3±3.2 years and 3.0±2.6 years, respectively. Replacement intervals were 14 days in 11 patients, 7 days in 4 patients, 28 days in 2 patients, and 21 days in 1 patient. One patient was unable to provide an accurate replacement interval. Eighteen (99%) caregivers had experience of adding volume to a cuff without pressure measure in the following instances: due to patients' needs in 7 cases, air leakage in 7 cases, and no reason in 4 cases. Mean pressure of tracheostomy cuff was 40±9.4 cmH2O, and air volume of tracheostomy cuff was 6.7±3.2 mL, but real mean volume was 7.0±2.9 mL. The number of suctioning for airway clearance was a mean 27.5±18.2 times a day.
According to this survey, we notice that almost all the patients and caregivers had an erroneous idea about cuff volume and pressure. Moreover, education and long-term professional care of tracheostomy cannot be overemphasized in this manner.
通过肌萎缩侧索硬化症(ALS)患者的照料者评估长期使用气管造口管的ALS患者的护理状况。
以问卷调查的形式对ALS患者及其照料者进行调查。所有测量均由两名访视护士进行。统计分析采用SPSS 22.0版软件及针对非正态分布的曼-惠特尼U检验。
共有19例患者(15例男性和4例女性)及其照料者参与了调查。就患者而言,平均护理时长为5.9±3.7年,平均病程和气管造口时长分别为5.3±3.2年和3.0±2.6年。更换间隔方面,11例患者为14天,4例患者为7天,2例患者为28天,1例患者为21天。1例患者无法提供准确的更换间隔。18名(99%)照料者有在以下情况下未进行压力测量就给套管充气的经历:因患者需要7例,漏气7例,无原因4例。气管造口套管的平均压力为40±9.4 cmH₂O,气管造口套管的气量为6.7±3.2 mL,但实际平均气量为7.0±2.9 mL。气道清理的吸痰次数平均每天为27.5±18.2次。
根据本次调查,我们注意到几乎所有患者和照料者对套管气量和压力都存在错误认知。此外,气管造口的教育和长期专业护理怎么强调都不为过。