Effects Of Ice Saline Spraying On Oral Mucosa To Relieve Thirst Patients With Dysphagia

ObjectiveTo explore whether ice saline can relieve thirst in patients with dysphagia in neurology department.To explore whether there is a difference in relieving thirst of patients with different temperatures of ice saline.To explore whether there is a correlation between NRS and the oral saliva p H value.MethodsThis study included 120 patients with dysphagia who met the inclusion criteria in the neurology ICU at a tertiary hospital in Inner Mongolia from November 2020 to August 2021,and were randomly divided into 2℃ice saline experimental group,6℃ice saline experimental group and control group,with 40 cases in each group.The control group used sterile cotton swabs dipped in normal saline to moisten the lips and tongue every 4 hours for 5 consecutive days.The 2℃and 6℃ice saline groups were respectively injected into the elephant nose watering pot and directly sprayed on the oral mucosa of the patients.The order is lips-left and right buccal-upper jaw-uvula-tongue surface-under tongue,spray every 4 hours,spray on each part for 5consecutive days.The score of oral and tongue mucous membrane,WHO oral mucosal classification and the oral saliva p H value were evaluated before the intervention and on the 1st day,3rd day and 5th day,and statistical analysis was conducted.The clinical effect of ice saline spraying oral mucosa to relieve thirst in patients with dysphagia was analyzed.Results(1)A total of 105 cases were collected(35 cases in control group,35 cases in2℃ice saline experimental group and 35 cases in 6℃ice saline experimental group).There was no statistically significant difference in demographic data,dysphagia grade,NRS,the score of oral and tongue mucous membrane,WHO oral mucosal grade and the oral saliva p H value in the three groups before the intervention(P>0.05).There were no statistical significant differences in oxygen supply mode,mouth breathing and balance of intake and intake of patients in the three groups on the 1st day,3rd day,and 5th day of intervention(P>0.05).(2)Comparison of the NRS:There were statistical significant differences in thirst at different time points before and after intervention in the control group,2℃ice saline experimental group and 6℃ice saline experimental group(P<0.05).There were statistical significant differences in NRS on the 1st day of intervention,but there was no statistical significant difference on the 3rd day and 5th day of intervention between the 2℃ice saline experimental group and the 6℃ice saline experimental group(P>0.05).There were statistical significant differences in NRS before intervention,on the 1st,3rd and 5th day of intervention between the two groups(P<0.05),and showed a gradual decreasing trend.(3)Comparison of the score of oral and tongue mucous membrane:There were statistical significant differences in the score of oral and tongue mucous membrane in the control group,2℃ice saline experimental group and 6℃ice saline experimental group(P<0.05).There was no statistical significant difference in the score of oral and tongue mucous membrane between the 2℃ice saline experimental group and the 6℃ice saline experimental group(P>0.05).(4)Comparison of the WHO oral mucosal grade:There were statistical significant differences in the WHO oral mucosal grade in the control group,2℃ice saline experimental group and 6℃ice saline experimental group(P<0.05).There was no statistical significant difference in the WHO oral mucosal grade between the 2℃ice saline experimental group and the 6℃ice saline experimental group(P>0.05).(5)Comparison of the p H value of oral saliva:There were statistical significant differences in the p H value of oral saliva at different time points before and after intervention in the control group,2℃ice saline experimental group and 6℃ice saline experimental group(P<0.05).There were statistical significant differences in the p H value of oral saliva on the 1st day of intervention,but there was no significant difference on the 3rd day and 5th day of intervention between the 2℃ice saline experimental group and the 6℃ice saline experimental group(P>0.05).There were statistical significant differences in the p H value of oral saliva before intervention,on the 1st,3rd and 5th day of intervention between the two groups(P<0.05),and showed a gradual increasing trend.(6)Correlation analysis between NRS and the oral saliva p H value:Spearman correlation analysis showed that there was a statistical significant negative correlation(r_s<0,P<0.05)and a moderate correlation(∣r_s∣≥0.4)between NRS and the oral saliva p H value in the 2℃ice saline experimental group on the 5th day of intervention.There was a statistical significant negative correlation(r_s<0,P<0.05)and a moderate negative correlation(∣r_s∣≥0.4)between the two groups in the 6℃ice saline experimental group and the control group from the beginning to the end of intervention.Conclusions(1)Ice saline can relieve thirst by spraying the oral mucosa of patients with dysphagia,and relieve the patient’s thirst,improve the score of oral and tongue mucous membrane and reduce the grade of patients’WHO oral mucosa were significantly better than that of wetting oral mucosa with cotton swabs.(2)There was no significantly in relieving thirst,improving the score of oral and tongue mucous membrane and reducing WHO oral mucosa grade between 2℃and6℃ice saline spraying.(3)The more thirsty you are,the lower your oral saliva p H value is.The severity of thirst can be judged by the p H value of oral saliva.(4)Ice saline is convenient and economical,and the method is simple,efficient,safe and effective,and suitable for clinical promotion.