摘要
目的 通过Meta分析,探讨中国脑卒中患者发生吞咽障碍的主要影响因素,为我国卒中后吞咽障碍(DAS)的预防管理工作提供参考依据.方法 计算机检索Cochrane、PubMed、Web of Science、中国知网、维普、万方、中国生物医学网等国内外数据库中有关DAS影响因素的横断面研究、队列研究或病例对照研究,检索时间从建库至 2023 年 2 月.采用RevMan 5.3 和Stata 17.0 软件进行Meta分析.结果 最终纳入17篇文献,其中病例对照研究15篇,队列研究2篇,累计研究对象4434例.Meta分析结果显示:年龄(OR=1.31,95%CI:1.17～1.47)、高血压(OR=2.34,95%CI:2.23～2.45)、糖尿病(OR=2.29,95%CI:1.79～2.92)、脑干梗死(OR=3.39,95%CI:2.34～4.92)、入院NIHSS评分(OR=6.61,95%CI:4.06～10.75)、BI指数(OR=0.59,95%CI:0.52～0.67)、进食时间＞30 min(OR=18.93,95%CI:5.89～60.85)、牙齿缺失≥6 颗(OR=3.76,95%CI:2.72～5.19)、肌力分级≤3 级(OR=3.05,95%CI:1.22～7.60)、食物类型(固体)(OR=9.85,95%CI:5.65～17.16)、进食依赖(喂食)(OR=6.52,95%CI:2.20～19.35)、多发性病灶(OR=4.53,95%CI:2.37～8.67)为卒中患者合并吞咽障碍的影响因素(P<0.05).结论 年龄、高血压、糖尿病、脑干梗死、入院NIHSS评分、BI指数、进食时间＞30 min、牙齿缺失≥6颗、肌力分级≤3级、食物类型(固体)、进食依赖(喂食)、多发性病灶为DAS的影响因素.医务人员要尤其注意对具有以上影响因素的脑卒中患者进行早期预防及治疗干预.
Abstract
Objective To explore the primary influencing factors of dysphagia in Chinese stroke patients through Meta-analysis,thereby providing reference basis for preventing and managing dysphagia after stroke(DAS)in China.Methods Computer searches of Cochrane Library,PubMed,Web of Science,China National Knowledge Infrastructure,VIP,Wanfang,China Biomedical Literature,and other domestic and foreign databases for cross-sectional studies,cohort studies or case-control studies on the influencing factors of DAS were conducted from inception to February 2023.Meta-analysis was performed using RevMan 5.3 and Stata 17.0 software.Results A total of 17 studies comprising 15 case-control studies and 2 cohort studies were included,involving total 4434 research subjects.The Meta-analysis results showed that the age(OR=1.31,95%CI:1.17～1.47),hypertension(OR=2.34,95%CI:2.23～2.45),diabetes mellitus(OR=2.29,95%CI:1.79～2.92),outcomes showed that brainstem stroke(OR=3.39,95%CI:2.34～4.92),admission NIHSS score(OR=6.61,95%CI:4.06～10.75),Barthel index(OR=0.59,95%CI:0.52～0.67),eating duration>30-minute(OR=18.93,95%CI:5.89～60.85),missing teeth≥6(OR=3.76,95%CI:2.72～5.19),muscle strength grading≤3(OR=3.05,95%CI:1.22～7.60),food type(solid)(OR=9.85,95%CI:5.65～17.16),eating dependency(feeding)(OR=6.52,95%CI:2.20～19.35),and multiple lesions(OR=4.53,95%CI:2.37～8.67)were the influencing factors for combined dysphagia in stroke patients(P<0.05).Conclusion The age,hypertension,diabetes mellitus,outcomes showed that brainstem stroke,admission NIHSS score,Barthel index,eating duration>30-minute,missing teeth≥6,muscle strength grading≤3,food type(solid),eating dependency(feeding),and multiple lesions were the influencing factors for DAS.Medical professionals should pay special attention to early preventive and therapeutic interventions for stroke patients with the aforementioned influencing factors.
基金项目
四川省2022年重点研发计划项目(2022JDKP0019)
维普
万方数据