经口气管插管患者流涎症影响因素和干预措施的研究进展

近年来，经口气管插管作为急危重症患者的有效救治措施之一，临床使用率达96%，随着其广泛使用并发症也日益突出，其中流涎症是经口气管插管患者临床较为常见且易被忽视的并发症之一。经文献调研发现，流涎症可造成经口气管插管患者皮肤和(或)黏膜感染、营养不良、声门下分泌物增多以及提高非计划性拔管和呼吸机相关性肺炎等事件的发生风险，是直接增加患者住院时长和医疗花费的重要因素之一。而且，研究表明经口气管插管患者流涎症的防治对预防呼吸机相关性肺炎有重要意义，但临床医护人员常忽视流涎症对呼吸机相关性肺炎的影响，对此无有效的管理措施，相关研究也较缺乏。基于多项流涎症影响因素的研究结果，本文总结出经口气管插管患者流涎症的影响因素包含唾液分泌异常、神经肌肉功能障碍、感觉障碍和医护人员认识相对不足4个方面，并根据现有流涎症的干预方法，对经口气管插管患者流涎症的防治措施进行了合理的展望，提出今后可增加对经口气管插管患者流涎症的现况调查、影响因素分析和干预措施3个方向的相关研究，为减少和预防经口气管插管患者流涎症及其并发症提供借鉴，以提高临床预防、治疗与护理的预见性和精准性及患者的住院舒适度。 

Research progress on the influencing factors and intervention measures of salivation in patients with trans-oral tracheal intubation

Currently, trans-oral tracheal intubation is one of the effective treatment measures for patients with acute and critical illness, with a clinical use rate of 96%. With its widespread use, complications have become increasingly prominent, amongst which salivation is one of the more common and overlooked clinical complications in patients with trans-oral tracheal intubation. According to literature research, salivation can cause skin and/or mucosal infections, malnutrition, aggregate subglottic secretions and increased risk of unplanned extubation and ventilator-related pneumonia in patients with trans-oral tracheal intubation. It is one of the important factors that increase the length of hospital stay and medical expenses. Furthermore, studies have shown that the prevention and treatment of salivation in patients with trans-oral tracheal intubation is of great significance to the occurrence of ventilator-associated pneumonia, but clinical medical and nursing staff often ignore the relevance of salivation to ventilator-associated pneumonia. No effective management measures are available for preventing salivation, and relevant studies are also lacking. On the basis of the results of multiple studies on the influencing factors of salivation, this paper summarises the influencing factors of salivation in patients with trans-oral tracheal intubation, including salivation abnormality, neuromuscular dysfunction, sensory impairment and the relative lack of awareness of medical and nursing staff. It also provides a reasonable outlook on the prevention and treatment measures of salivation in patients with trans-oral tracheal intubation on the basis of existing intervention methods for salivation. In the future, studies on the current survey, analysis of influencing factors and intervention measures for salivation in patients with trans-oral tracheal intubation should be conducted. Relevant research in each direction provides reference for reducing and preventing salivation and its complications in patients with trans-oral tracheal intubation, so as to improve the predictability and precision of clinical prevention, treatment and nursing, as well as the comfort of patients in the hospital.