目的 分析气管插管患者拔管后吞咽障碍相关研究的热点及发展趋势。方法 系统检索中国知网、Web of Science数据库中关于气管插管患者拔管后吞咽障碍的研究,运用CiteSpace 5.8R3可视化软件对文献进行分析。结果 共纳入中文文献119篇,英文文献408篇,发文量总体呈上升趋势。关键词分析发现,研究热点主要集中在并发症、风险因素、筛查与管理等方面,中文文献形成吞咽障碍、危险因素、气管插管、误吸、营养、吞咽评估共6个聚类,英文文献形成dysphagia（吞咽障碍）、airway management（气道管理）、management（管理）、endotracheal intubation（气管插管）、muscle skeletal（肌肉骨骼）、aspiration（误吸）、cardiac surgery（心脏手术）共7个聚类;关键词突现分析发现,并发症管理和症状评估是拔管后吞咽障碍的研究前沿。结论 气管插管患者拔管后吞咽障碍聚焦于重症、心脏外科术后及颈椎骨折的患者,中英文文献的研究主题及类型存在差异,护理在拔管后吞咽障碍管理中起到重要作用。我国护理工作者今后应借鉴国外经验,以提升患者经口进食的安全性、促进早期恢复经口进食为目的 ,开发具有特异性的评估工具,制订规范化拔管后吞咽评估与管理流程。
Objective To analyze the research hotspot and development trend of post-extubation dysphagia in patients with tracheal intubation. Methods The researches on dysphagia after tracheal extubation were systematically searched from CNKI and Web of science database,and the literatures were analyzed by CiteSpace 5.8.R3 visualization software. Results A total of 119 Chinese literature and 408 English literature were included,and the number of published papers showed an increasing trend. Keyword analysis found that research hotspots mainly focused on complications,risk factors,screening and management,etc. Chinese literature formed 6 clusters,namely dysphagia,risk factors,tracheal intubation,aspiration,nutrition and swallowing evaluation. English literature included 7 clusters,namely dysphagia,airway management,management,endotracheal intubation,muscle skeletal,aspiration,cardiac surgery. Keyword emergence analysis showed that complication management and symptom evaluation were the frontiers of the research on post-extubation dysphagia. Conclusion Dysphagia after tracheal extubation is mainly focused on patients with severe disease,cardiac surgery and cervical fracture. There are differences in the research topics and types between Chinese and English literature. Nursing plays an important role in the management of dysphagia after extubation. In the future,Chinese nursing workers can learn from foreign experience to develop specific assessment tools and standardize post-extubation swallowing assessment and management procedures in order to improve the safety of oral eating and promote early recovery from oral eating.
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