关键词: ICU；气管插管；获得性吞咽障碍；危险因素

Abstract: Objective: To investigate the occurrence and risk factors of ICU acquired dysphagia. Methods: The prospective cohort study was conduct from April 2017 to December 2017 at Respiratory Intensive Care Unit and Surgical Intensive Care Unit of Beijing Chao-yang Hospital. According to continuous sampling and convenient sampling method, tracheal intubation and extubation patients who were admitted to our hospital and met with the inclusion criteria were selected. The self-designed questionnaire was used to collect the observation indexes related to dysphagia in the enrolled patients, and swallowing function was assessed by Standardized Swallowing Assessment scale 4 hours after tracheal extubation. Results: A total of 154 patients were enrolled in this study, including 55 patients with dysphagia, the incidence rate was 35.7%, but for the prolonged extubation (≥2 d) patients, the incidence increased to 64.1%. By logistic regression analysis, three related factors were identified for acquired swallowing disorders, which were the duration of endotracheal intubation (P=0.001, OR=2.099), APACHE II score (P<0.001, OR=1.324) and arrhythmia (P=0.022, OR=4.177). Conclusion: The incidence of ICU acquired dysphagia was high, especially for delayed extubation patients, the incidence was significantly increased. Prolonged mechanical ventilation time, increased APACHE II score and arrhythmia are the risk factors of ICU acquired swallowing disorders. This suggests that the medical staff should pay higher attention to patients with these characteristics, assess the swallow function early after extubation and identify high-risk patients.

Key words: Intensive Care Unit; tracheal intubation; acquired dysphagia; risk factors