| Objective To explore the effects of different cuff pressure values on swallowing function and aspiration pneumonia in stroke patients with tracheotomy and non-mechanical ventilation,in order to provide scientific basis for cuff pressure management methods in stroke patients with tracheotomy and non-mechanical ventilation.Methods A total of 94 patients with cerebral apoplexy who received treatment in the rehabilitation department of a Grade-Ⅲ hospital in Hangzhou from October 2022 to February 2023 and met the inclusion and exclusion criteria were selected as research objects and randomly divided into group A(20～25cmH2O cuff pressure group).Group B(26～30cmH2O cuff pressure group),47 cases in each group.All the study subjects used high volume and low pressure cuff with artificial airway with subglottic suction.The measuring tool was Cohui 109-02 hand-held pressure gauge,and the inflation pressure was higher than the ideal value of 2cmH2O in each manual pressure measurement according to the guidelines.On the basis of the implementation of conventional rehabilitation treatment and nursing measures,patients in group A and group B were given two kinds of pressure control interval of 20～25cmH2O and 26～30cmH2O,and the cuff pressure was re-measured every 6 hours,so that the cuff was in the inflated state and maintained in the corresponding control interval as far as possible.The swallowing function and the incidence of aspiration pneumonia were compared between different cuff pressure management groups before intervention and 1 month after intervention.Results 1.A total of 94 cases were included in this study.There were no statistically significant differences in age,gender,education level,marital status,medical payment method,stroke type,smoking history,drinking history,hypertension history,diabetes history,nutritional status and nutritional supply routes between the two groups(P>0.05),indicating that patients in the two groups were comparable.2.There were no significant differences in the severity score of swallowing disorder(VFSS)and incidence of aspiration pneumonia between 2 groups before intervention(P>0.05).3.Five cases were shed during the intervention,including 3 cases in group A and 2 cases in group B.Finally,44 cases in group A and 45 cases in group B were included.4.After one month of intervention,VFSS scores and pharyngeal VFSS scores of both groups were increased,but the difference was statistically significant(P<0.05).With the extension of time,the increase of VFSS score in the two groups was different,and the increase of VFSS score in group A was larger.Independent sample t test was used to compare the VFSS scores of the two groups before intervention and 1 month after intervention,and the difference was statistically significant(P<0.05).5.The incidence of aspiration pneumonia in 2 groups before and after intervention was statistically significant(P<0.05),and the incidence of aspiration pneumonia in 2 groups was decreased.After 1 month of intervention,there was no significant difference in the incidence of aspiration pneumonia between the two groups(P>0.05).Conclusion 1.Both of the two methods of cuff pressure management can improve the swallowing function of stroke patients recovering from tracheotomy and non-mechanical ventilation,but the combination of cuff pressure control and rehabilitation training is more helpful to the recovery of swallowing function of patients.2.Both of the two methods of cuff pressure management can reduce the incidence of aspiration pneumonia in patients with stroke who recover from tracheotomy and nonmechanical ventilation,and the effect difference is not obvious.In the long run,the recovery of swallowing function can also reduce the incidence of aspiration pneumonia. |
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