比較冷生理食鹽水噴霧與冷蒸餾水噴霧對緩解口渴的成效──以加護病房氣管內管留置病人為例

The Comparative Effectiveness of Using Cold Water Oral Spray and Cold Saline Oral Spray for Thirst Relief in Patients With Endotracheal Intubation in the Intensive Care Unit

背景：口渴是加護病房氣管內管留置病人常見的症狀，病人口渴比例高達88%。
目的：以加護病房放置氣管內管病人為研究對象，比較冷生理食鹽水噴霧與冷蒸餾水噴霧緩解口渴的成效及探討兩組在緩解口渴的維持和持續效果。
方法：研究對象來自於大台北地區某醫學中心內科加護病房氣管內管留置病人，將病人隨機分配至冷生理食鹽水組（n = 18）與冷蒸餾水組（n = 18）。冷生理食鹽水組接受3次2℃−8℃冷生理食鹽水噴霧，每次朝向病人口腔四個面向各噴10下，等待5分鐘，重複該過程，共3回，每次介入間隔時間為30分鐘。冷蒸餾水組則使用2℃−8℃冷蒸餾水，其餘介入步驟同生理食鹽水組。以數字評分量尺（Numeric Rating Scale）測量兩組三次介入措施前後的口渴強度，及以查閱病歷獲得病人基本資料及生理狀態的數值。
結果：每次冷生理食鹽水噴霧與冷蒸餾水噴霧介入皆可緩解病人口渴強度，而兩組在每次介入後的口渴強度緩解程度無差異。只有冷蒸餾水組有口渴強度的維持效果，而兩組皆有口渴強度的持續效果。
結論：兩組措施皆可緩解病人口渴，而冷蒸餾水組同時具有維持效果及持續效果，故以冷蒸餾水噴霧方式可作為臨床護理人員緩解氣管內管留置病人口渴照護的參考。

Background: Thirst is a common symptom among patients with endotracheal intubation in the intensive care unit (ICU), with an estimated prevalence of 88%.
Purpose: This study was designed to compare the effectiveness of cold saline spray and cold water spray in alleviating thirst, and to explore the maintenance and sustained effects of both groups in relieving thirst among patients with endotracheal intubation in the ICU.
Methods: Patients with indwelling tracheal tubes in the medical ICU were recruited from one medical center in northern Taiwan and randomly assigned to either the cold saline (n = 18) or cold water (n = 18) group. The cold saline group received three rounds of cold saline spray at a temperature of 2℃–8℃. Each round consisted of 10 sprays directed toward each of the four surfaces of the oral cavity followed by a 5-minute wait period. This process was repeated three times, with 30-minute intervals between interventions. The cold water group received the same intervention steps using a cold water spray at 2℃–8℃. Thirst intensity was measured using a numeric rating scale before and after each of the three interventions in both groups. Demographic and relevant physiological data were collected on the participants by reviewing their medical records.
Results: Both of the interventions were found to effectively alleviate thirst intensity, with no significant difference between the two groups in terms of thirst intensity reduction after each intervention detected. Only the cold water spray had a maintenance effect, while the two groups had a continuous sustained effect in alleviating thirst intensity.
Conclusion: Both of the interventions effectively alleviated thirst, and the cold water spray had both maintenance and sustained effects in alleviating thirst intensity. Based on the results, the cold water spray method may be considered as the priority treatment for thirst alleviation by healthcare providers in the clinical management of patients with tracheal intubation.