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重复经颅磁刺激治疗脑卒中后吞咽障碍的有效性:一项随机对照试验的荟萃分析。

Effectiveness of repetitive transcranial magnetic stimulation on poststroke dysphagia: a meta-analysis of randomized-controlled trials.

机构信息

Affiliated Zhejiang Hospital, Zhejiang University School of Medicine Zhejiang, China.

出版信息

Int J Rehabil Res. 2022 Jun 1;45(2):109-117. doi: 10.1097/MRR.0000000000000517. Epub 2022 Jan 27.

Abstract

Dysphagia is a common functional impairment after stroke, resulting in aspiration of liquids, ingested foods, or oral secretions and influencing the quality of life. Noninvasive repetitive transcranial magnetic stimulation has been widely used for rehabilitation of dysphagia. The purpose of this meta-analysis was to investigate the efficacy of repetitive transcranial magnetic stimulation on poststroke swallowing impairment. Four databases were systematically searched for eligible studies from their inception to 31 September 2021. Review Manager 5.4 software was used for this meta-analysis. The bias of included randomized controlled trials was assessed using the version 2 of the Cochrane risk-of-bias tool for randomized trials. Nine randomized controlled trials involving 393 patients were included according to the selection criteria. The results revealed significant benefit of repetitive transcranial magnetic stimulation as a treatment of dysphagia following the onset of stroke, when compared with intervention without repetitive transcranial magnetic stimulation. Applying repetitive transcranial magnetic stimulation on different stimulation sites effectively improved the dysphagia of poststroke patients, and no significant difference was observed among the different stimulation sites subgroups. Our findings support repetitive transcranial magnetic stimulation as an effectively treatment of the poststroke dysphagia, especially in unilateral hemispheric stroke patients.

摘要

吞咽障碍是脑卒中后的常见功能障碍,可导致液体、摄入的食物或口腔分泌物吸入,并影响生活质量。非侵入性重复经颅磁刺激已广泛用于吞咽障碍的康复治疗。本荟萃分析旨在探讨重复经颅磁刺激对脑卒中后吞咽障碍的疗效。从研究开始到 2021 年 9 月 31 日,我们系统性地在四个数据库中搜索了符合条件的研究。使用 Review Manager 5.4 软件进行荟萃分析。使用 Cochrane 随机对照试验偏倚风险工具(版本 2)评估纳入的随机对照试验的偏倚。根据选择标准,共纳入了 9 项随机对照试验,涉及 393 名患者。结果表明,与无重复经颅磁刺激干预相比,重复经颅磁刺激作为脑卒中后吞咽障碍的治疗方法具有显著益处。在不同的刺激部位应用重复经颅磁刺激可有效改善脑卒中后患者的吞咽障碍,且不同刺激部位亚组之间无显著差异。我们的研究结果支持重复经颅磁刺激作为脑卒中后吞咽障碍的有效治疗方法,特别是在单侧半球性脑卒中患者中。

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