Foley Norine, Teasell Robert, Salter Katherine, Kruger Elizabeth, Martino Rosemary
Lawson Health Research Institute, Parkwood Hospital, Rm B-3019b, 801 Commissioner's Rd. E. London, ON N6C 5J1, Canada.
Age Ageing. 2008 May;37(3):258-64. doi: 10.1093/ageing/afn064.
dysphagia is common following stroke and is associated with the development of pneumonia. Many dysphagia treatment options are available, some still experimental and others already rooted in common practice. Previous reviews of these treatments were limited due to a dearth of available studies. Recently, more trials have been published warranting a re-examination of the evidence.
a systematic review of all randomised controlled trials (RCTs), updating previous work and evaluating a broader range of therapeutic interventions intended for use in adults recovering from stroke and dysphagia.
using multiple databases, we identified RCTs published between the years 1966 and August 2007 examining the efficacy of dysphagia therapies following stroke. Across studies, results of similar treatments and outcomes were compared and evaluated.
fifteen articles were retrieved assessing a broad range of treatments that included texture-modified diets, general dysphagia therapy programmes, non-oral (enteral) feeding, medications, and physical and olfactory stimulation. Across the studies there was heterogeneity of the treatments evaluated and the outcomes assessed that precluded the use of pooled analyses. Descriptively these findings present emerging evidence that nasogastric tube feeding is not associated with a higher risk of death compared to percutaneous feeding tubes; and general dysphagia therapy programmes are associated with a reduced risk of pneumonia in the acute stage of stroke.
dysphagia is known to be a common and potentially serious complication of stroke. Despite the recent newly published RCTs, few utilise the same treatment and outcomes thereby limiting the evidence to support the medical effectiveness of common dysphagia treatments used for patients recovering from stroke.
吞咽困难在中风后很常见，且与肺炎的发生有关。有多种吞咽困难治疗方案可供选择，有些仍处于实验阶段，其他一些则已成为常规做法。由于可用研究匮乏，以往对这些治疗方法的综述受到限制。最近，更多试验已发表，有必要重新审视相关证据。
对所有随机对照试验（RCT）进行系统综述，更新以往工作，并评估一系列更广泛的治疗干预措施，这些措施旨在用于中风后吞咽困难的成年康复患者。
我们使用多个数据库，识别1966年至2007年8月期间发表的RCT，这些RCT研究了中风后吞咽困难治疗的疗效。在各项研究中，对相似治疗方法和结果进行了比较和评估。
检索到15篇文章，评估了广泛的治疗方法，包括质地改良饮食、一般吞咽困难治疗方案、非经口（肠内）喂养、药物以及物理和嗅觉刺激。在各项研究中，所评估的治疗方法和所评估的结果存在异质性，这使得无法进行汇总分析。从描述性角度来看，这些发现表明有新证据显示，与经皮喂食管相比，鼻胃管喂养与更高的死亡风险无关；一般吞咽困难治疗方案与中风急性期肺炎风险降低有关。
已知吞咽困难是中风常见且可能严重的并发症。尽管最近有新发表的RCT，但很少有研究采用相同的治疗方法和结果，因此限制了支持用于中风康复患者的常见吞咽困难治疗方法医学有效性的证据。
