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全喉切除术后伴或不伴咽食管重建的口咽吞咽障碍的诊断和治疗:系统评价。

Diagnosis and treatment of oropharyngeal dysphagia after total laryngectomy with or without pharyngoesophageal reconstruction: Systematic review.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.

School for Mental Health and Neuroscience - MheNs, Maastricht University Medical Center, Maastricht, The Netherlands.

出版信息

Head Neck. 2018 Dec;40(12):2733-2748. doi: 10.1002/hed.25508. Epub 2018 Nov 26.

Abstract

BACKGROUND

This systematic review qualitatively summarizes the current literature on diagnosis and treatment of oropharyngeal dysphagia (OD) after total laryngectomy (TLE).

METHODS

Electronic databases PubMed, Embase, and the Cochrane Library were used. Two independent reviewers carried out the literature search and assessed the methodological quality of the included studies using a critical appraisal tool.

RESULTS

Forty-four articles met the inclusion criteria. Of these, 35 studies were on diagnosis, four on therapy, and five on both diagnosis and treatment of OD following TLE. Study aims, swallowing-assessment methods, and main findings of the included studies were summarized and presented.

CONCLUSIONS

The reviewers found heterogeneous outcomes and serious methodological limitations, which prevented us from pooling data to identify trends that would assist in designing best clinical practice protocols for OD following TLE. Further research should focus on several remaining gaps in our knowledge on diagnosis and treatment interventions for OD following TLE.

摘要

背景

本系统评价定性总结了目前关于全喉切除术后口咽吞咽困难(OD)的诊断和治疗的文献。

方法

使用电子数据库 PubMed、Embase 和 Cochrane Library。两名独立的审查员进行文献检索,并使用批判性评估工具评估纳入研究的方法学质量。

结果

44 篇文章符合纳入标准。其中,35 篇研究是关于诊断的,4 篇研究是关于治疗的,5 篇研究是关于全喉切除术后 OD 的诊断和治疗的。总结并介绍了纳入研究的研究目的、吞咽评估方法和主要发现。

结论

审查员发现结果存在异质性和严重的方法学局限性,这使得我们无法汇总数据以确定有助于设计全喉切除术后 OD 最佳临床实践方案的趋势。进一步的研究应集中在我们对全喉切除术后 OD 的诊断和治疗干预措施的几个尚存的知识空白上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b211/6587738/0c5e3b411332/HED-40-2733-g001.jpg

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