ICU气管插管患者拔管后吞咽功能障碍的相关因素研究进展  

Research progress on factors related to post-extubation dysphagia in ICU patients with tracheal intubation

作　　者：熊泽忠 周宏伟[2] 韦有全[3] XIONG Zezhong;ZHOU Hongwei;WEI Youquan(Intensive Care Medicine DivisionⅠ,the Second People’s Hospital of Qinzhou,Guangxi,Qinzhou 535000,China;Respiratory and Critical Care Medicine DivisionⅠ,the Second People’s Hospital of Qinzhou,Guangxi,Qinzhou 535000,China;Department of Anesthesiology,the Second People’s Hospital of Qinzhou,Guangxi,Qinzhou 535000,China)

机构地区：[1]广西壮族自治区钦州市第二人民医院重症医学科一区,广西钦州535000 [2]广西壮族自治区钦州市第二人民医院呼吸与危重症医学科一区,广西钦州535000 [3]广西壮族自治区钦州市第二人民医院麻醉科,广西钦州535000

出　　处：《中国医药科学》2024年第12期17-21,共5页China Medicine And Pharmacy

基　　金：广西壮族自治区钦州市科学研究与技术开发计划项目(20199501);广西临床重点专科建设(培育)项目(2021-21)。

摘　　要：在重症监护室(ICU)的治疗环境中,长期机械通气将对患者的喉部结构与功能带来一系列的负面影响,特别是在进行气管插管拔除后。吞咽功能障碍的发生不仅局限于吞咽困难和食物残留,其还同时可伴随声音嘶哑、咳嗽和呛咳等症状,严重时甚至会导致患者发生吸入性肺炎和营养不良。影响吞咽功能的因素较复杂,包括肌肉萎缩、神经控制损伤、喉反射减退、心理因素以及整体身体状况等。本文综述ICU气管插管患者在拔管后吞咽功能障碍的病因、影响因素,并对现行的治疗干预措施进行阐述,旨在为临床医生提供有关吞咽功能障碍的治疗参考。对制订个体化的治疗方案,减少并发症的风险,加快患者康复具有重要意义,同时也为未来的研究方向和临床实践提供了新的视角。In the treatment environment of the intensive care unit(ICU),long-term mechanical ventilation will have a range of negative effects on the structure and function of the patient’s throat,especially after extubation.The occurrence of post-extubation dysphagia is not limited to swallowing difficulties and food residue,but can also be accompanied by symptoms such as hoarseness,cough,and choking.In severe cases,it can even lead to aspiration pneumonia and malnutrition in patients.The factors that affect swallowing function are complex,including muscle atrophy,nerve control damage,decreased laryngeal reflex,psychological factors,and overall physical condition.This article reviews the etiology and influencing factors of dysphagia in ICU patients after extubation,and elaborates on current treatment interventions,aiming to provide clinical doctors with treatment references on post-extubation dysphagia.These pieces of information are of great significance for developing individualized treatment plans,reducing the risk of complications,accelerating patient recovery,and providing new perspectives for future research directions and clinical practice.

关 键 词：重症监护室气管插管 拔管后吞咽功能障碍 相关因素 研究进展 

分 类 号：R459.7[医药卫生—急诊医学]