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缺血性脑卒中患者吞咽困难的危险因素:Meta 分析和系统评价。

Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review.

机构信息

Department of Neurology, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China.

Division of Rheumatology, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China.

出版信息

PLoS One. 2022 Jun 16;17(6):e0270096. doi: 10.1371/journal.pone.0270096. eCollection 2022.

Abstract

BACKGROUND

Dysphagia is a common yet serious complication in stroke patients. We aimed to conduct a meta-analysis and systematic review to evaluate the risk factors of dysphagia in patients with ischemic stroke, to provide insights to the clinical treatment and nursing care of dysphagia.

METHODS

We searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Database, China Biomedical Literature Database (CBM) for studies on dysphagia in patients with ischemic stroke up to January 31, 2022. The quality of the literature was evaluated using the Newcastle-Ottawa scale. Meta-analysis was performed using RevMan 5.3 software.

RESULTS

A total of 10 studies involving 4637 ischemic stroke patients were included, 1183(25.51%) patients had dysphagia after stroke. The synthesized outcomes showed that elder age (SMD = 0.42, 95%CI:0.34-0.50), hypertension (OR = 1.96, 95%CI:1.48-2.61), diabetes (OR = 1.83, 95%CI:1.47-2.28), brainstem stroke (OR = 2.12, 95%CI:1.45-3.09) were associated with dysphagia in patients with ischemic stroke (all P<0.05). There was no significant difference in the gender between dysphagia and no dysphagia patients (OR = 1.07, 95%CI:0.91-1.27, P = 0.40). Egger regression tests indicated there were no significant publication biases in the synthesized outcomes (all P>0.05).

CONCLUSIONS

Elder age, hypertension, diabetes and brainstem stroke are associated with the development of dysphagia in patients with ischemic stroke. Attention should be paid to the assessment and early intervention of those risk factors for dysphagia to improve the prognosis of stroke patients.

摘要

背景

吞咽困难是脑卒中患者常见且严重的并发症。本研究旨在进行荟萃分析和系统评价,以评估缺血性脑卒中患者发生吞咽困难的危险因素,为吞咽困难的临床治疗和护理提供参考。

方法

检索 PubMed、Embase、Cochrane 图书馆、Web of Science、中国知网(CNKI)和万方数据库、中国生物医学文献数据库(CBM),搜集关于缺血性脑卒中患者吞咽困难的相关文献,检索时限截至 2022 年 1 月 31 日。采用 Newcastle-Ottawa 量表对文献质量进行评价,采用 RevMan 5.3 软件进行荟萃分析。

结果

共纳入 10 项研究,包含 4637 例缺血性脑卒中患者,1183 例(25.51%)患者发生卒中后吞咽困难。Meta 分析结果显示,高龄(SMD = 0.42,95%CI:0.34-0.50)、高血压(OR = 1.96,95%CI:1.48-2.61)、糖尿病(OR = 1.83,95%CI:1.47-2.28)、脑干卒中(OR = 2.12,95%CI:1.45-3.09)是缺血性脑卒中患者发生吞咽困难的危险因素(均 P<0.05),而性别(OR = 1.07,95%CI:0.91-1.27,P = 0.40)与吞咽困难无明显相关性。Egger 检验结果表明,各结局指标的发表偏倚均无统计学意义(均 P>0.05)。

结论

高龄、高血压、糖尿病和脑干卒中与缺血性脑卒中患者吞咽困难的发生有关。应重视对这些吞咽困难危险因素的评估和早期干预,以改善脑卒中患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbf9/9202855/3d31905f5522/pone.0270096.g001.jpg

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