摘要
咳嗽是机体的防御性神经反射,对清除呼吸道分泌物和有害因子有重要作用.人工气道患者咳嗽强度评估与气道廓清、误吸预防、机械通气脱机及气管导管拔除等结局密切相关,如何根据患者病情和临床特征进行个性化、科学的咳嗽强度评估是实施精准干预及疗效评价的基础.本文对目前国内外常见咳嗽强度评估工具的评估方式、特点及其应用现状进行综述,评估工具主要包括咳嗽呼气峰值流速、白卡试验、简化咳嗽试验、半定量咳嗽强度评分、反射性咳嗽强度分级、膈肌移动度、气囊压力变化值、腹内压变化值及胃内压变化值等,以期为人工气道患者咳嗽强度评估工具的开发和应用提供借鉴,为科学评估咳嗽强度、制订个性化干预措施提供依据.
Abstract
Cough is a defensive nerve reflex of the body,which plays an important role in clearing respiratory secretions and harmful factors.The evaluation of cough strength in patients with artificial airway is closely related to outcomes such as airway clearance,aspiration prevention,mechanical ventilation weaning,and tracheal tube removal.How to conduct personalized and scientific cough strength evaluation based on the patient's condition and clinical characteristics is the basis for implementing precise intervention and efficacy evaluation.This article reviews evaluation methods,characteristics,and current application status of common cough strength evaluation tools both domestically and internationally.The evaluation tools mainly include cough peak expiratory flow,white card test,simplified cough test,semi-quantitative cough strength score,reflex cough strength grading,diaphragm excursion,delta cuff pressure,delta intra-abdominal pressure,and delta gastric pressure.It aims to provide reference for the development and application of cough strength evaluation tools for artificial airway patients,and to provide basis for scientific evaluation of cough strength and formulation of personalized intervention measures.
基金项目
南方医科大学南方医院院长基金项目(2022H007)
NETL
NSTL
万方数据