探索拔管后患者嗓音和吞咽功能综合筛查的可行性:试点研究

Fernanda Figueroa-Martínez, Adrián Castillo-Allendes, Karla Grunewaldt, Tamara Solís-Meza, Eric J. Hunter, Jeffrey R Searl
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摘要

研究目的本试验研究旨在为智利拔管后患者确定和测试一系列省时、经济有效的嗓音和吞咽筛查工具。方法。由四位专家组成的小组对嗓音和吞咽筛查工具进行了筛选和评分。筛选出的七种工具包括:用于嗓音评估的平滑前频谱峰突度 (CPPS) 和最大发音时间 (MPT)、用于吞咽的容积-粘度吞咽测试 (V-VST)、用于咳嗽评估的自主和反射性咳嗽流量峰值、进食评估工具-10 (EAT-10) 以及用于患者报告结果的嗓音症状量表 (VoiSS)。这些工具适用于出院后 48-72 小时内的四名拔管后患者,同时还对 17 名匹配的对照组患者进行了评估。结果显示与对照组相比,拔管后患者的 MPT 明显缩短,CPPS 值降低,V-VST 吞咽困难体征增加,自主咳嗽峰值流量降低,VoiSS 和 EAT-10 的症状更加明显。局限性。该研究的样本量有限,且仅依赖于临床筛查工具。这项试点研究为拔管后患者的嗓音和吞咽筛查提供了一种可行且具有成本效益的方法,在资源有限的环境中很有价值。虽然这些可使用的工具并非黄金标准评估,但它们提供了有价值的见解,可指导未来的研究。本研究强调了所选工具在促进早期发现拔管后患者嗓音和吞咽障碍方面的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring the Feasibility of a Comprehensive Screening for Voice and Swallowing Function in Post-Extubation Patients: A Pilot Study
Objectives. This pilot study aimed to identify and test a battery of time-efficient and cost-effective voice and swallowing screening tools for post-extubated patients in Chile. Methods. A panel of four experts selected and rated voice and swallowing screening tools. Seven measures were selected: smoothed cepstral peak prominence (CPPS) and maximum phonation time (MPT) for voice assessment, Volume-Viscosity Swallow Test (V-VST) for swallowing, voluntary and reflex peak cough flow for cough assessment, Eating Assessment Tool-10 (EAT-10), and Vocal Symptom Scale (VoiSS) for patient-reported outcomes. These tools were applied to four post-extubation patients within 48-72 hours post-hospital discharge, alongside the assessment of 17 matched controls. Results. Post-extubation patients showed significantly shorter MPT, lower CPPS values, increased V-VST dysphagia signs, reduced voluntary peak cough flow, and more pronounced symptoms on both the VoiSS and EAT-10 compared to controls. Limitations. The study had a modest sample size and relied solely on clinical screening tools.Value. This pilot study suggests a feasible and cost-effective approach to voice and swallowing screening for post-extubation patients, valuable in resource-constrained settings.Conclusion. While these accessible tools are not gold-standard assessments, they offer valuable insights and can guide future research. This study underscores the potential of selected tools in facilitating early detection of voice and swallowing disorders in post-extubation patients.
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