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ICU 拔管后吞咽困难的危险因素:系统评价和荟萃分析。

Risk factors for post-extubation dysphagia in ICU: A systematic review and meta-analysis.

机构信息

Nursing Department, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China.

College of Nursing, Weifang Institute of Science and Technology, Shandong, Weifang, People's Republic of China.

出版信息

Medicine (Baltimore). 2023 Mar 10;102(10):e33153. doi: 10.1097/MD.0000000000033153.

Abstract

BACKGROUND

Post-extubation dysphagia is high in critically ill patients and is not easily recognized. This study aimed to identify risk factors for acquired swallowing disorders in the intensive care unit (ICU).

METHODS

We have retrieved all relevant research published before August 2022 from PubMed, Embase, Web of Science, and the Cochrane Library electronic databases. The studies were selected using inclusion and exclusion criteria. Two reviewers screened studies, extracted data, and independently evaluated the risk of bias. The quality of the study was assessed with the Newcastle-Ottawa Scale, and a meta-analysis was carried out with Cochrane Collaboration's Revman 5.3 software.

RESULTS

A total of 15 studies were included. Age (odds ratio [OR] = 1.04), tracheal intubation time (OR = 1.61), APACHE II (OR = 1.04), and tracheostomy (OR = 3.75) were significant risk factors that contributed to post-extubation dysphagia in ICU.

CONCLUSION

This study provides preliminary evidence that post-extraction dysphagia in ICU is associated with factors such as age, tracheal intubation time, APACHE II, and tracheostomy. The results of this research may improve clinician awareness, risk stratification, and prevention of post-extraction dysphagia in the ICU.

摘要

背景

危重症患者拔管后吞咽困难的发生率较高,且不易被识别。本研究旨在确定重症监护病房(ICU)中获得性吞咽障碍的危险因素。

方法

我们检索了 2022 年 8 月前在 PubMed、Embase、Web of Science 和 Cochrane 图书馆电子数据库中发表的所有相关研究。使用纳入和排除标准筛选研究。两名审查员筛选研究、提取数据,并独立评估偏倚风险。使用纽卡斯尔-渥太华量表评估研究质量,并使用 Cochrane 协作 Revman 5.3 软件进行荟萃分析。

结果

共纳入 15 项研究。年龄(比值比[OR] = 1.04)、气管插管时间(OR = 1.61)、APACHE II(OR = 1.04)和气管切开术(OR = 3.75)是导致 ICU 拔管后吞咽困难的显著危险因素。

结论

本研究初步证明 ICU 拔管后吞咽困难与年龄、气管插管时间、APACHE II 和气管切开术等因素有关。该研究结果可能提高临床医生对 ICU 拔管后吞咽困难的认识、风险分层和预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d97b/9997834/bf53754bd702/medi-102-e33153-g001.jpg

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