Decannulation of dysphagic patients after a tracheotomy
10.3760/cma.j.issn.0254-1424.2020.10.005
- VernacularTitle:喉镜吞咽功能评估指导气管切开合并吞咽障碍患者拔管的应用分析
- Author:
Zhiming TANG
1
;
Hongmei WEN
;
Ziyang XU
;
Zitong HE
;
Peixia CHEN
;
Delian AN
;
Xiaomei WEI
;
Guifang WAN
;
Zulin DOU
Author Information
1. 中山大学附属第三医院康复医学科，广州 510630
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2020;42(10):886-889
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of flexible endoscopic evaluation of swallowing (FEES) in guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.Methods:The FEES results of 188 neurological disease patients with dysphagia who had undergone a tracheotomy were analyzed retrospectively. The utility of FEES evaluation indexes (including glottis activity, the classification of pharyngeal secretions and residues as well as penetration-aspiration grade) for predicting the success of decannulation was explored.Results:One hundred and nine of the patients (the success group) were decannulated successfully and 79 (the failure group) were not, a success rate of 57%. The abnormal glottis activity rate among the failure group was 55%, significantly higher than among the success group (21%). The pharyngeal secretion classifications and penetration-aspiration grades among the success group were also significantly lower than among the failure group, on average. The average course of recovery from the tracheotomy was 184 days in the success group, significantly shorter than that of the failure group (292 days). No significant differences in residues were observed.Conclusion:The glottis activity, secretions and intake aspiration evaluated using FEES are of great value for guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.
