重症卒中呼吸康复策略：从循证实践到精准康复的展望Respiratory Rehabilitation Strategies for Severe Stroke: A Review from Evidence-Based Practice to Precision Rehabilitation

重症卒中后呼吸功能障碍常合并呼吸中枢驱动失调、呼吸泵衰竭及气道保护失效等多类复杂且异质的病理机制，传统康复模式难以满足个体化临床需求。本文综述了以精准评估为导向的整合性呼吸康复框架。该框架以多模态生理评估为基础，构建重症卒中患者呼吸功能特征图谱，进而为多学科团队制订个体化干预方案提供依据。尽管目前该领域仍面临高级别证据不足等挑战，但未来结合人工智能辅助决策与靶向神经调控技术的精准康复模式，或将为重症卒中呼吸康复的发展提供新思路。Respiratory dysfunction after severe stroke often involves multiple complex and heterogeneous pathological mechanisms, including dysregulated central respiratory drive, respiratory pump failure, and airway protection failure. Conventional rehabilitation models are difficult to meet individualized clinical demands. This paper reviews an integrated respiratory rehabilitation framework guided by precision assessment. Based on multi-modal physiological assessments, this framework constructs a respiratory function profile for patients with severe stroke, thereby providing evidence for the multi-disciplinary team to formulate individualized intervention protocols. Although the field still faces challenges such as insufficient high-level evidence, precision rehabilitation models, which integrate artificial intelligence-assisted decision-making and targeted neuromodulation technology, may provide new insights into the development of respiratory rehabilitation in severe stroke.