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辣椒素雾化诱发咳嗽对出血性脑卒中气管切开患者痰液排出的影响:一项随机对照试验

Effect of Capsaicin Atomization-Induced Cough on Sputum Excretion in Tracheotomized Patients After Hemorrhagic Stroke: A Randomized Controlled Trial.

作者信息

Wu Chao, Zhang Yijie, Yang Li, Shen Fang, Ma Chen, Shen Meifen

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

Nursing Department, Dushu Lake Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

J Speech Lang Hear Res. 2021 Nov 8;64(11):4085-4095. doi: 10.1044/2021_JSLHR-21-00151. Epub 2021 Oct 25.

Abstract

Background Timely and effective removal of respiratory secretions is of great significance for tracheotomized patients. The purpose of this study is to investigate the effectiveness of capsaicin nebulization to stimulate cough to promote early clearance of respiratory secretions in tracheotomized patients after hemorrhagic stroke. Method This study implemented a randomized controlled design. Sixty-three patients who were tracheotomized following a hemorrhagic stroke completed this randomized controlled trial. In the control group, 33 cases were given a routine care after tracheotomy. In the intervention group, 30 cases were given a capsaicin solution nebulization in addition to the routine care. The daily sputum output and the number of sputum suctioning were observed. The differences in sputum viscosity, cough function, and Clinical Pulmonary Infection Score (CPIS) were compared between the two groups before and after the intervention. Vital sign changes during capsaicin nebulization and suctioning were compared between the two groups in a pilot study. Results The daily sputum output of the capsaicin intervention group was significantly higher than that of the control group ( < .05). The number of sputum suctioning of capsaicin group was less than that of the control group after intervention ( < .05). The CPIS score of the capsaicin group was lower than that of the control group ( < .05) after a 1-week intervention. Patients' heart rate, respiratory rate, and oxygen saturation during capsaicin nebulization were not statistically different from those during routine sputum suctioning ( > .05). Conclusions Capsaicin atomization-induced cough can effectively promote sputum excretion of hemorrhagic stroke patients undergoing tracheotomy and has a good safety profile. The Clinical Trial registration number of this study is ChiCTR2000037772 (http://www.chictr.org.cns). Supplemental Material https://doi.org/10.23641/asha.16821352.

摘要

背景 及时有效地清除呼吸道分泌物对气管切开患者具有重要意义。本研究旨在探讨辣椒素雾化刺激咳嗽对促进出血性中风后气管切开患者呼吸道分泌物早期清除的有效性。方法 本研究采用随机对照设计。63例出血性中风后行气管切开的患者完成了这项随机对照试验。对照组33例,气管切开后给予常规护理。干预组30例,在常规护理基础上给予辣椒素溶液雾化。观察每日痰液排出量和吸痰次数。比较两组干预前后痰液黏稠度、咳嗽功能和临床肺部感染评分(CPIS)的差异。在一项预试验中比较两组在辣椒素雾化和吸痰过程中的生命体征变化。结果 辣椒素干预组的每日痰液排出量显著高于对照组(<0.05)。干预后辣椒素组的吸痰次数少于对照组(<0.05)。1周干预后辣椒素组的CPIS评分低于对照组(<0.05)。辣椒素雾化期间患者的心率、呼吸频率和血氧饱和度与常规吸痰期间相比无统计学差异(>0.05)。结论 辣椒素雾化诱导咳嗽可有效促进出血性中风气管切开患者痰液排出,且安全性良好。本研究的临床试验注册号为ChiCTR2000037772(http://www.chictr.org.cn)。补充材料https://doi.org/10.23641/asha.16821352

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