重症患者气管插管拔管后吞咽障碍早期康复方案构建OA

Objective Based on the best evidence,an early rehabilitation program for post-extubation dysphagia in critically ill patients with tracheal intubation was constructed,providing a theoretical basis for reducing complications after tracheal intubation in patients in intensive care unit(ICU)and improving the quality of life of patients.Methods A literature review method was used to systematically search and analyze relevant literature,so as to summarize the best evidence for patients with post-extubation dysphagia.On this basis,the Delphi method was adopted to conduct two rounds of expert consultation,and finally the early rehabilitation program was constructed.Results A total of 15 experts were invited in this study.Through two rounds of consultation,the effective recovery rate of the expert consultation questionnaire in each round was 100%,indicating high enthusiasm of the experts.The authority coefficient of the overall program questionnaire was 0.86.The Kendall's coefficients of two rounds of expert consultation were 0.311 and 0.342 respectively(P<0.01).Finally,an early rehabilitation program for post-extubation dysphagia in ICU patients with tracheal intubation was formed,which included 4 first-level items,20 second-level items and 40 third-level items.The program consisted of four parts:team building,rehabilitation assessment,nursing and rehabilitation measures,and nursing evaluation.Conclusion This program is practical,scientific and systematic,and is suitable for post-extubation dysphagia patients.It can help them recover swallowing function as soon as possible.