Abstract:
As a key treatment for critically ill patients, tracheotomy can effectively maintain airway patency, whereas may change the anatomical structure of the upper respiratory tract and weaken the defense function, often causing multiple dysfunctions in breathing, swallowing and speech and seriously affecting the quality of life and rehabilitation process of patients. Optimizing airway management, reducing related complications, promoting the recovery of respiratory function, and finally achieving safe and efficient extubation have become the core problems to be urgently solved in clinical practice. Respiratory, swallowing, speech and cough functions are intimately correlated with anatomical structure, physiological mechanism and nerve regulation. Any functional impairment among these may affect the overall rehabilitation effect. Subglottic positive pressure technology reconstructs subglottic pressure environment through exogenous airflow, and partially restores the aerodynamic characteristics of the upper respiratory tract. It plays a role in improving airway patency, enhancing airway protection function, reconstructing subglottic pressure and promoting breathing-swallowing coordination, which is expected to achieve coordinated multifunctional rehabilitation. As a new rehabilitation method, this technology has shown high clinical value in assisted phonation, secretion clearance and treatment of dysphagia. However, the research on coordinated multifunctional rehabilitation of patients undergoing tracheotomy is still relatively limited. Unified standards and evidence-based data are lacking in terms of the mechanism, parameter optimization and individualized application. In this article, the mechanism, clinical application status, existing problems and future research direction of subglottic positive pressure technology in coordinated multifunctional rehabilitation of patients undergoing tracheotomy were systematically reviewed, aiming to provide reference for optimizing rehabilitation strategies, promoting standardized application of this technology and improving clinical prognosis.