Meta-analysis of the application effects of three nutritional management models in stroke patients with dysphagia
Objective To explore the application effect of different nutritional management models in stroke patients with dysphagia.Methods PubMed,Web of Science,Embase,the Cochrane Library,CNKI,China Biomedical Literature Database,VIP and Wanfang Database were searched by computer to collect ran-domized controlled trials(RCT)on nutritional management of stroke patients with dysphagia published from the establishment of the database to July 2023.RevMan5.4 software was used to meta-analyse the data.Re-sults A total of 13 articles were included,including 1 322 stroke patients with dysphagia and three nutrition management models(multidisciplinary collaborative management,cluster management,and individualized management).The results of meta-analysis showed that all three nutritional management models could im-prove the serum albumin level of stroke patients with dysphagia,and the difference was statistically significant[mean difference(MD)=4.46,95％confidence interval(95％CI)2.55-6.38,P＜0.000 01].All the three nutrition management models could improve the swallowing function of patients,and the difference was statis-tically significant[relative risk(RR)=1.21,95％CI 1.11-1.32,P＜0.000 1].Both the multidisciplinary col-laborative management model and the individualized management model could improve the pre-serum protein level of patients,and the difference was statistically significant(MD=14.99,95％CI 9.90-20.07,P＜0.000 01).The individualized management model could improve the hemoglobin level of patients,and the difference was statistically significant(MD=5.56,95％CI 2.83-8.30,P＜0.000 1).The bundle management model could improve the triceps skinfold thickness,upper arm muscle circumference,triglyceride and total cholesterol,and the differences were statistically significant(MD=2.47,95％CI 1.54-3.39,P＜0.000 01);MD=6.74,95％CI 5.89-7.60,P＜0.000 01;MD=0.62,95％CI 0.51-0.74,P＜0.000 01;MD=1.05,95％CI 0.22-1.87,P=0.01).Both multidisciplinary collaborative management mode and individualized management mode could reduce the incidence of adverse reactions in patients,and the difference was statisti-cally significant(RR=0.36,95％CI 0.18-0.72,P=0.004;RR=0.32,95％CI 0.20-0.52,P＜0.000 01).Conclusion The three nutritional management models can improve the nutritional status and swallowing function of patients,and the appropriate nutritional management model can be selected based on the individual patient's situation in clinical work.
万方数据
维普
