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呼吸训练对吞咽障碍吞咽功能的影响:系统评价和荟萃分析。

Effect of respiratory training on swallowing function in swallowing disorders: a systematic review and meta-analysis.

机构信息

Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.

出版信息

Eur Arch Otorhinolaryngol. 2024 Mar;281(3):1069-1081. doi: 10.1007/s00405-023-08280-7. Epub 2023 Oct 16.

Abstract

PURPOSE

To determine the clinical efficacy of different respiratory training interventions on swallowing function in patients with swallowing disorders through the systematic review.

METHODS

We reviewed the literature regarding the application of respiratory training therapy in patients with swallowing disorders, followed by a PRISMA search of published literature in five databases (PubMed, Web of Science, The Cochrane Library, CINAHL and EMBASE) in December 2022. Two reviewers performed study selection, quality evaluation, and risk of bias, followed by data extraction and detailed analysis.

RESULTS

A total of six randomized controlled studies with a total sample size of 193 cases were included. Respiratory training improved swallowing safety (PAS (n = 151, SMD = 0.69, 95% CI - 1.11 to - 0.26, I = 36, p < 0.001)) and swallowing efficiency [residual (n = 63, SMD = 1.67, 95% CI - 2.26 to - 1.09, I = 23%, p < 0.001)] compared to control groups. The results of the qualitative analysis conducted in this study revealed that respiratory training enhanced hyoid bone movement but had no effect on swallowing quality of life.

CONCLUSIONS

Respiratory training interventions may improve swallowing safety and efficiency in patients with dysphagia. However, the level of evidence is low, and there is a limited amount of research on the effectiveness and physiology of this intervention to improve swallowing function. In the future, there is a need to expand clinical studies, standardize measurement tools, and improve study protocols.

摘要

目的

通过系统评价,确定不同呼吸训练干预措施对吞咽障碍患者吞咽功能的临床疗效。

方法

我们检索了呼吸训练疗法在吞咽障碍患者中的应用文献,随后于 2022 年 12 月在五个数据库(PubMed、Web of Science、The Cochrane Library、CINAHL 和 EMBASE)中进行了 PRISMA 文献检索。两名审查员进行了研究选择、质量评估和偏倚风险评估,随后进行了数据提取和详细分析。

结果

共纳入 6 项随机对照研究,总样本量为 193 例。呼吸训练可改善吞咽安全性(PAS(n=151,SMD=0.69,95%CI-1.11 至-0.26,I²=36,p<0.001))和吞咽效率[残留量(n=63,SMD=1.67,95%CI-2.26 至-1.09,I²=23%,p<0.001)]优于对照组。本研究的定性分析结果表明,呼吸训练可增强舌骨运动,但对吞咽生活质量无影响。

结论

呼吸训练干预措施可能改善吞咽障碍患者的吞咽安全性和效率。但是,证据水平较低,关于这种干预措施改善吞咽功能的有效性和生理学的研究有限。未来需要扩大临床研究,规范测量工具,并改进研究方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6399/10858149/632128c9d961/405_2023_8280_Fig1_HTML.jpg

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