关键词: 重症肺炎, 气管插管, 吞咽障碍, 吞咽功能, 康复训练, 儿童

Abstract: Objective To explore the clinical application effect of swallowing function training combined with pacifier sucking in children with acquired dysphagia after tracheal intubation and extubation in severe pneumonia,and to provide guidance and reference for promoting in-depth development of rehabilitation training for dysphagia after tracheal intubation and extubation in children with severe pneumonia.Methods A retrospective analysis was conducted in 120 children with severe pneumonia admitted to the Department of Critical Care Medicine of our hospital from July 2019 to September 2023 who underwent endotracheal intubation(intubation time≥5 days) and developed post-extubation swallowing dysfunction.Take the beginning of the study on swallowing function training combined with pacifiers in July 2021 as the boundary.The cases before the study was carried out were set as the control group,and the cases when the study was carried out and implemented were set as the observation group,with 60 cases in each group.The control group received routine care after extubation,while the observation group received swallowing function training combined with pacifier sucking.After the intervention,the results of recovery of swallowing function,the rate of aspiration by mistake,the incidence of aspiration pneumonia,reintubation rate,the rate of returning to ICU and other indicators were evaluated.Results The standardized swallowing assessment(SSA) scores of the observation group were significantly lower than those of the control group at 4 hours，24 hours,48 hours and 72 hours after intervention,and on discharge,and the difference was statistically significant(P<0.01).The total effective rate of improvement in swallowing function of children in the observation group was 100.0%(60/60),which was higher than 86.7%(52/60) in the control group,and the difference was statistically significant(P<0.01).The total incidence rate of complications in the observation group was 16.7%(10/60),which was lower than 73.3%(44/60) in the control group,among which the rate of aspiration by mistake,the incidence of aspiration pneumonia, reintubation rate and the rate of returning to ICU were all lower than those in the control group,and the difference was of statistical significance(P<0.05).Conclusion Swallowing function training combined with pacifier sucking can effectively improve the swallowing function of children with dysphagia after tracheal intubation and extubation in severe pneumonia and reduce the occurrence of related complications.

Key words:

Severe pneumonia, Tracheal intubation, Dysphagia, Swallowing function, Rehabilitation training, Child