ICU经口气管插管患者拔管后吞咽障碍康复训练的最佳证据总结

doi:10.3761/j.issn.2096-7446.2025.04.019

摘要/Abstract

摘要：

目的检索、评价并总结ICU气管插管患者拔管后吞咽障碍康复训练的最佳证据。方法系统检索计算机决策系统、指南网站、专业协会网站和数据库中的临床决策、指南、最佳实践、专家共识、证据总结、系统评价及原始研究等，检索时限为建库至2024年9月9日，由4名经过循证培训的研究者独立完成文献质量评价、证据提取、汇总与分级。结果最终纳入20篇文献，从吞咽康复训练的多学科团队、训练评估、训练措施、效果评价、健康教育和注意事项6个维度汇总了22条证据。结论该研究总结的ICU气管插管患者拔管后吞咽障碍康复训练的最佳证据具有一定的科学性和实用性，临床实践中需结合具体情况，针对性地选择应用证据，以改善患者预后，提升护理质量。

关键词: 重症监护室, 经口气管插管, 拔管后吞咽障碍, 康复训练, 证据总结, 循证护理学

Abstract:

Objective To retrieve，evaluate，and summarize the best evidence for swallowing rehabilitation training in ICU patients with post-extubation dysphagia，providing a reference for clinical application. Methods To address the issues related to swallowing rehabilitation training for ICU patients with post-extubation dysphagia，we systematically searched the clinical decision-making systems，guideline websites，professional association websites，and databases for clinical decisions，guidelines，best practice，expert consensus，evidence summaries，systematic reviews，and original studies. The search period was from database inception to September 9，2024. Four evidence-based trained researchers independently conducted quality assessment of the literature and evidence extraction. Results A total of 20 studies were included，and 22 pieces of evidence were summarized across six dimensions：multidisciplinary teams for swallowing rehabilitation，training assessment，training measures，outcome evaluation，health education，and precautions. Conclusion The best evidence summarized in this study for swallowing rehabilitation training in ICU patients with post-extubation dysphagia demonstrates scientific rigor and practicality. In clinical practice，evidence should be applied selectively based on specific circumstances to improve patient outcomes and enhance the quality of care.

Key words: Intensive Care Units, Tracheal Intubation, Post-Extubation Dysphagia, Rehabilitation, Evidence Summary, Evidence-Based Nursing

郑艳敏, 黄泽曦, 黄娅若, 崔念奇, 马雪芩, 沙瑞芹, 刘永刚, 田莹. ICU经口气管插管患者拔管后吞咽障碍康复训练的最佳证据总结[J]. 中华急危重症护理杂志, 2025, 6(4): 487-493.

ZHENG Yanmin, HUANG Zexi, HUANG Yaruo, CUI Nianqi, MA Xueqin, SHA Ruiqin, LIU Yonggang, TIAN Ying. Summary of the best evidence for dysphagia rehabilitation training in ICU patients after extubation of orotracheal intubation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(4): 487-493.

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