中华护理杂志 ›› 2026, Vol. 61 ›› Issue (19): 2716-2722.DOI: 10.3761/j.issn.0254-1769.2026.19.018
收稿日期:2025-12-16
出版日期:2026-10-10
发布日期:2026-09-28
*通讯作者:
徐佳敏,女,本科,主管护师,E-mail:278502049@qq.com作者简介:第一联系人: 徐佳敏:选题设计、文献检索与分析、论文撰写与修改;帅琴燕:选题设计、研究指导、论文审阅与修改
Received:2025-12-16
Online:2026-10-10
Published:2026-09-28
* Corresponding author:
XU Jiamin,E-mail:278502049@qq.com摘要:
ICU获得性吞咽障碍是重症患者常见并发症之一,可增加误吸、营养不良、肺部感染等不良结局风险,严重影响患者的预后与生活质量。吞咽肌群训练作为非侵入性的干预手段,具有操作简便、安全性高的特点,已被证实可改善患者的吞咽功能。该文围绕ICU获得性吞咽障碍的发生机制,系统综述国内外吞咽肌群训练的理论依据、训练方式及训练形式、临床效果,同时分析现有研究的局限性,旨在为临床优化ICU获得性吞咽障碍患者的吞咽肌群训练方案提供理论指导。
徐佳敏, 帅琴燕. 吞咽肌群训练在ICU获得性吞咽障碍患者中应用的研究进展[J]. 中华护理杂志, 2026, 61(19): 2716-2722.
XU Jiamin, SHUAI Qinyan. Research progress on the application of swallowing muscle training in patients with ICU-acquired swallowing disorders[J]. Chinese Journal of Nursing, 2026, 61(19): 2716-2722.
| [1] |
Macht M, Wimbish T, Bodine C, et al. ICU-acquired swallowing disorders[J]. Crit Care Med, 2013, 41(10):2396-2405.
DOI PMID |
| [2] | 李华强, 高佳新, 刘建成, 等. 重症监护室获得性吞咽障碍发病率的Meta分析[J]. 中国呼吸与危重监护杂志, 2023, 22(7):492-499. |
| Li HQ, Gao JX, Liu JC, et al. Meta-analysis of the morbidity of acquired swallowing disorders in intensive care unit patients[J]. Chin J Respir Crit Care Med, 2023, 22(7):492-499. | |
| [3] |
Skoretz SA, Flowers HL, Martino R. The incidence of dysphagia following endotracheal intubation:a systematic review[J]. Chest, 2010, 137(3):665-673.
DOI PMID |
| [4] |
Zuercher P, Moret CS, Dziewas R, et al. Dysphagia in the in-tensive care unit:epidemiology,mechanisms,and clinical mana-gement[J]. Crit Care, 2019, 23(1):103.
DOI |
| [5] |
戚春霞, 厉春林, 张雅芝, 等. 重症患者ICU获得性吞咽障碍影响因素的Meta分析[J]. 中华护理杂志, 2021, 56(8):1236-1241.
DOI URL |
| Qi CX, Li CL, Zhang YZ, et al. Dysphagia in the intensive care unit:a meta-analysis of risk factors[J]. Chin J Nurs, 2021, 56(8):1236-1241. | |
| [6] |
Skurok P, Johnston BW, Brown E, et al. Effects of expiratory muscle strength training on swallowing in survivors of critical illness:a protocol for a systematic review and meta-analysis[J]. Health Sci Rep, 2025, 8(2):e70337.
DOI URL |
| [7] |
Sasegbon A, Cheng I, Hamdy S. The neurorehabilitation of post-stroke dysphagia:physiology and pathophysiology[J]. J Physiol, 2025, 603(3):617-634.
DOI URL |
| [8] |
Park JS, Cho YS, Morishita M, et al. Effect of multidirectional chin tuck against resistance exercise on oropharyngeal muscles and swallowing function in subacute stroke patients with dys- phagia:a randomised controlled trial[J]. J Oral Rehabil, 2025, 52(7):1050-1058.
DOI URL |
| [9] | Mittal RK. Motor function of the pharynx,esophagus,and its sphincters[M]. San Rafael: Morgan & Claypool Life Sciences, 2011. |
| [10] |
Park JS, Hwang NK, Kim HH, et al. Effects of lingual strength training on oropharyngeal muscles in South Korean adults[J]. J Oral Rehabil, 2019, 46(11):1036-1041.
DOI URL |
| [11] |
Cheng I, Hamdy S. Metaplasticity in the human swallowing system:clinical implications for dysphagia rehabilitation[J]. Neurol Sci, 2022, 43(1):199-209.
DOI |
| [12] |
Montoro-Huguet MA. Dietary and nutritional support in gas-trointestinal diseases of the upper gastrointestinal tract(I):esophagus[J]. Nutrients, 2022, 14(22):4819.
DOI URL |
| [13] | Turra GS, Schwartz IVD, Almeida ST, et al. Efficacy of speech therapy in post-intubation patients with oropharyngeal dyspha-gia:a randomized controlled trial[J]. Codas, 2021, 33(2):e20190246. |
| [14] |
Wu CP, Xu YJ, Wang TG, et al. Effects of a swallowing and oral care intervention for patients following endotracheal extubation:a pre- and post-intervention study[J]. Crit Care, 2019, 23(1):350.
DOI |
| [15] | Park JS, Hwang NK. Chin tuck against resistance exercise for dysphagia rehabilitation:a systematic review[J]. J Oral Reha-bil, 2021, 48(8):968-977. |
| [16] | 王瑞华. 神经原性吞咽障碍的评定与康复[J]. 中国康复理论与实践, 2002, 8(2):109-112. |
| Wang RH. Evaluation and rehabilitation of neurogenic dys-phagia[J]. Chin J Rehabil Theory Pract, 2002, 8(2):109-112. | |
| [17] | Jansen M, van Iperen ID, Kroner A, et al. Kangaroo stimula-tion game in tracheostomized intensive care-related dyspha-gia:interventional feasibility study[J]. JMIR Serious Games, 2025, 13:e60685. |
| [18] | Deng W, Zeng XF, Zhang LY, et al. The management of sarco-penic dysphagia:a multidisciplinary approach leveraging emer-ging technologies[J]. Aging Dis, 2024, 16(5):2752-2769. |
| [19] |
Chacko SA, Ramamoorthy L, Cherian A, et al. Effectiveness of swallowing and oral care interventions on oral intake and salivary flow of patients following endotracheal extubation at a tertiary care center:a randomized controlled trial[J]. J Caring Sci, 2023, 12(4):213-220.
DOI URL |
| [20] | 中国康复医学会吞咽障碍康复专业委员会, 窦祖林, 温红梅, 等. 中国吞咽障碍康复管理指南(2023版)[J]. 中华物理医学与康复杂志, 2023, 45(12):1057-1072. |
| Dysphagia Rehabilitation Professional Committee in Chinese Association of Rehabilitation Medicine, Dou ZL, Wen HM, et al. China guidelines for the rehabilitation management of dys-phagia(2023 edition)[J]. Chin J Phys Med Rehabil, 2023, 45(12):1057-1072. | |
| [21] | Dai M, Cheng I, Sasegbon A, et al. A Meta-analysis and sys-tematic review of the effects of sensory modulation treat-ments for neurogenic oropharyngeal dysphagia[J]. CNS Neuro-sci Ther, 2025, 31(7):e70452. |
| [22] |
Nagami S, Kouda M, Nakamura K, et al. Effects of active in-terferential current stimulation on swallowing function in patients with dysphagia:a cross-sectional study[J]. Dysphagia, 2025, 40(5):1263-1273.
DOI |
| [23] | 沈于琪. 风油精K点刺激在ICU气管插管拔管后吞咽障碍患者的干预效果研究[D]. 成都: 电子科技大学, 2025. |
| Shen YQ. Intervention effect of K-point stimulation with essen-tial balm on patients with dysphagia after tracheal intubation and extubation in ICU[D]. Chengdu: University of Electronic Science and Technology of China, 2025. | |
| [24] | 曹拂晓, 张飞飞, 林其昌, 等. 电刺激联合冰刺激训练对气管插管拔管后吞咽障碍的疗效观察[J]. 浙江医学, 2023, 45(2):197-198,208. |
| Cao FX, Zhang FF, Lin QC, et al. Observation on the thera-peutic effect of electric stimulation combined with ice stimulation training on dysphagia after tracheal intubation and extubation[J]. Zhejiang Med J, 2023, 45(2):197-198,208. | |
| [25] |
Assoratgoon I, Shiraishi N, Tagaino R, et al. Sen-sory neuromu-scular electrical stimulation for dysphagia rehabilitation:a literature review[J]. J Oral Rehabil, 2023, 50(2):157-164.
DOI URL |
| [26] | Suntrup S, Teismann I, Wollbrink A, et al. Pharyngeal electri-cal stimulation can modulate swallowing in cortical process-ing and behavior-magnetoencephalographic evidence[J]. Neuroi-mage, 2015, 104:117-124. |
| [27] |
Koestenberger M, Neuwersch S, Hoefner E, et al. A pilot study of pharyngeal electrical stimulation for orally intubated ICU patients with dysphagia[J]. Neurocritical Care, 2020, 32(2):532-538.
DOI PMID |
| [28] |
Suntrup-Krueger S, Labeit B, von Itter J, et al. Treating postex-tubation dysphagia after stroke with pharyngeal electrical stimulation-insights from a randomized controlled pilot trial[J]. Neurotherapeutics, 2025, 22(4):e00613.
DOI URL |
| [29] | 梁国兴. 酸冰刺激联合神经肌肉电刺激治疗ICU获得性吞咽功能障碍的临床应用研究[D]. 广州: 广州体育学院, 2021. |
| Liang GX. Clinical effects of acid ice stimulation combined with neuromuscular electrical stimulation in the treatment of ICU-acquired swallowing dysfunction[D]. Guangzhou: Guangzhou Sport University, 2021. | |
| [30] |
Frost J, Robinson HF, Hibberd J. A comparison of neuromus-cular electrical stimulation and traditional therapy,versus traditional therapy in patients with longstanding dysphagia[J]. Curr Opin Otolaryngol Head Neck Surg, 2018, 26(3):167-173.
DOI PMID |
| [31] | 谢纯青, 赵妃, 杨晨, 等. 简易咳嗽反射诱发试验预测吞咽障碍患者隐性误吸的敏感性及特异性评价[J]. 中华物理医学与康复杂志, 2023, 45(12):1110-1113. |
| Xie CQ, Zhao F, Yang C, et al. The sensitivity and specificity of the simplified cough provoking test in predicting aspira-tion in persons with dysphagia[J]. Chin J Phys Med Reha-bil, 2023, 45(12):1110-1113. | |
| [32] | 贾乐乐. 预见性护理在ICU气管插管患者吞咽功能管理中的应用研究[D]. 呼和浩特: 内蒙古医科大学, 2023. |
| Jia LL. A study on the application of predictive nursing in swallowing function management of ICU patients with endo-tracheal intubation[D]. Hohhot: Inner Mongolia Medical Univer-sity, 2023. | |
| [33] |
Templeman L, Roberts F. Effectiveness of expiratory muscle strength training on expiratory strength,pulmonary function and cough in the adult population:a systematic review[J]. Physiotherapy, 2020, 106:43-51.
DOI PMID |
| [34] |
Clayton NA, Ward EC, Nicholls C, et al. The addition of res-piratory muscle strength training to facilitate swallow and pulmonary rehabilitation following massive tissue loss and severe deconditioning:a case series[J]. Aust Crit Care, 2022, 35(2):210-216.
DOI URL |
| [35] | Hu ZY, Xie LN, Liang GM, et al. Application of the plan-do-check-act cycle in reducing the incidence of dysphagia in oral cancer patients after radical surgery[J]. J Multidiscip Heal-thc, 2026, 19:1-12. |
| [36] | 吴雪婷, 陈蕾, 王国州, 等. ICU病人气管插管拔管后吞咽障碍康复护理干预方案的构建[J]. 护理研究, 2024, 38(13):2383-2389. |
| Wu XT, Chen L, Wang GZ, et al. Construction of rehabilitation nursing intervention program for ICU patients with post-extubation swallowing dysfunction[J]. Chin Nurs Res, 2024, 38(13):2383-2389. | |
| [37] | 胡碎钗, 王丹进, 陈洁, 等. ICU获得性吞咽障碍基于HACCP原则的康复方案的建立与应用[J]. 中华全科医学, 2023, 21(2):350-353. |
| Hu SC, Wang DJ, Chen J, et al. Establishment and application of a rehabilitation program based on the HACCP principles for ICU-acquired dysphagia[J]. Chin J Gen Pract, 2023, 21(2):350-353. | |
| [38] |
郑艳敏, 黄泽曦, 黄娅若, 等. 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.
DOI |
| Zheng YM, Huang ZX, Huang YR, et al. Summary of the best evidence for dysphagia rehabilitation training in ICU patients after extubation of orotracheal intubation[J]. Chin J Emerg Crit Care Nurs, 2025, 6(4):487-493. | |
| [39] | 黄师菊, 蔡有弟, 李晓玲, 等. 护士主导的高危科室吞咽障碍患者筛查及分级干预效果评价[J]. 中华护理杂志, 2018, 53(11):1303-1308. |
| Huang SJ, Cai YD, Li XL, et al. The effectiveness of screening and grading intervention for dysphagia in high-risk depart-ments in all hospital led by nurses[J]. Chin J Nurs, 2018, 53(11):1303-1308. | |
| [40] |
Brodsky MB, Pandian V, Needham DM. Post-extubation dyspha-gia:a problem needing multidisciplinary efforts[J]. Intensive Care Med, 2020, 46(1):93-96.
DOI PMID |
| [41] | 彭倩倩, 孙瑞祥, 徐小盼, 等. ICU获得性吞咽障碍早期康复的最佳证据总结[J]. 中华危重病急救医学, 2025, 37(8):755-761. |
| Peng QQ, Sun RX, Xu XP, et al. Summary of the best evidence for early rehabilitation of ICU-acquired swallowing dysfunc-tion[J]. Chin Crit Care Med, 2025, 37(8):755-761. | |
| [42] |
唐佳迎, 黄晓霞, 郭芝廷, 等. 气管插管患者拔管后吞咽障碍风险管理研究[J]. 中华护理杂志, 2025, 60(1):52-60.
DOI URL |
| Tang JY, Huang XX, Guo ZT, et al. Research on a crisis management-based risk management protocol for dysphagia after extubation in patients with tracheal intubation[J]. Chin J Nurs, 2025, 60(1):52-60. |
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