戴允蘭 章微微 孫鵬 曾雅琴

[摘要] 目的 探討撳針聯(lián)合坐位咳嗽療法對(duì)治療腦卒中后氣管切開患者頑固性呃逆的臨床療效。 方法 選取浙江省人民醫(yī)院2018年11月至2020年10月收治的腦卒中后氣管切開頑固性呃逆住院患者52例，根據(jù)隨機(jī)數(shù)字表法將其分為觀察組和對(duì)照組，每組各26例，觀察組采取撳針聯(lián)合坐位咳嗽療法治療頑固性呃逆，對(duì)照組采取常規(guī)的鹽酸氯丙嗪注射液+鹽酸甲氧氯普胺注射液（胃復(fù)安）聯(lián)合治療，療程均為6 d。通過對(duì)兩組患者治療前后的生活質(zhì)量評(píng)分、呃逆癥狀積分、咳嗽反射分級(jí)量表評(píng)分等觀察指標(biāo)進(jìn)行科學(xué)評(píng)價(jià)，觀察其最終的臨床療效。 結(jié)果 治療后，與對(duì)照組相比，觀察組的呃逆癥狀積分[（4.62±1.53）分 vs. （3.12±1.03）分]、咳嗽反射分級(jí)量表評(píng)分[（2.35±0.63）分 vs. （1.69±0.55）分]均降低，觀察組的生活質(zhì)量評(píng)分[（10.15±1.38）分 vs. （11.38±1.79）分]、總有效率（92.3% vs. 73.1%）均增高（P<0.05）。 結(jié)論 撳針聯(lián)合坐位咳嗽誘發(fā)與常規(guī)的藥物治療對(duì)腦卒中后氣管切開患者的頑固性呃逆均有一定的療效，但前者的治療效果優(yōu)于后者，可明顯提高患者的生活質(zhì)量，改善患者的呃逆癥狀，前者對(duì)咳嗽反射重塑效果明顯優(yōu)于后者，可以進(jìn)一步促進(jìn)氣道分泌物的排出，值得臨床推廣應(yīng)用。

[關(guān)鍵詞] 撳針;坐位咳嗽;腦卒中;氣管切開;頑固性呃逆

[中圖分類號(hào)] R473.6;R744.5? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1673-9701（2021）24-0028-05

Observation of curative effect of sitting position cough therapy combined with press needle on obstinate hiccup in patients with post-stroke tracheotomy

DAI Yunlan? ?ZHANG Weiwei? ?SUN Peng? ?ZENG Yaqin

Department of Rehabilitation Medicine， Zhejiang Provincial People′s Hospital， People′s Hospital of Hangzhou Medical College， Hangzhou? ?310014， China

[Abstract] Objective To explore the clinical effect of needle-embedding combined with sitting cough induction on intractable hiccups in patients with tracheotomy after stroke. Methods A total of 52 tracheotomy patients with intractable hiccups after stroke admitted to Zhejiang Provincial People′s Hospital from November 2018 to October 2020 were selected and divided into observation group and control group according to the random number table method， with 26 cases in each group. The observation group was treated with needle-embedding combined with sitting cough induction for the treatment of intractable hiccups， and the control group was treated with conventional chlorpromazine hydrochloride injection combined with metoclopramide hydrochloride injection （metoclopramide）. The course of treatment was six days. Through scientific evaluation of the quality of life scores， hiccup symptom scores， cough reflex grading scale scores of the two groups before and after treatment， the final clinical efficacy was observed. Results After treatment， compared with （4.62±1.53） points and （2.35±0.63） points in the control group， the scores of hiccups [（3.12±1.03） points] and cough reflex grading scale scores [（1.69±0.55） points] in the observation group were all decreased. Compared with （10.15±1.38） points and （73.1%） in the control group， the quality of life scores [（11.38±1.79） points] and total effective rate （92.3%） of the observation group increased （P<0.05）. Conclusion Needle-embedding combined with sitting cough induction and conventional medical treatment have certain effects on intractable hiccups after tracheotomy in patients with stroke， but the former has better therapeutic effects than the latter， which can significantly improve the quality of life of patients and improve patients′ hiccup symptoms. The former has a significantly better effect on remodeling the cough reflex than the latter， which can further promote the discharge of airway secretions and is worthy of clinical application.