摘要
目的系统评价急性脑卒中患者吞咽障碍状况。方法在PubMed、EMbase、Web of Science、The Cochrane Library、中国生物医学文献数据库(CBM)、维普(VIP)、中国知网(CNKI)及万方(WanFang)等数据库进行文献检索,汇集有关急性脑卒中患者吞咽障碍检出率的研究,检索时限为建库至2021年11月5日。分别由2名护理研究者根据文献的纳入和排除标准对检索得到的文献进行独立筛选、资料提取并评价纳入文献的偏倚风险后,应用Stata16软件进行Meta分析。结果最终共纳入29篇文献,包括26799例调查对象。Meta分析结果显示,急性脑卒中患者吞咽障碍检出率为53%(95%CI:0.46~0.60)。亚组分析结果显示,男性为20%(95%CI:0.17~0.22),女性为20%(95%CI:0.17~0.24);50岁以下患者检出率为6%(95%CI:-0.03~0.15),50~59岁患者检出率为9%(95%CI:0.04~0.15),60~69岁患者检出率为26%(95%CI:-0.04~0.56),70~79岁患者检出率为29%(95%CI:0.03~0.54),80岁及以上患者检出率为39%(95%CI:-0.24~1.03);脑干、小脑、大脑、脑干+小脑、脑干+半球卒中患者吞咽障碍检出率分别为39%、13%、21%、33%、90%;完全前循环梗死、部分前循环梗死、后循环梗死、腔隙性梗死患者的吞咽障碍检出率分别为58%、25%、26%、16%;心源性脑卒中、大血管闭塞、小血管闭塞、动脉粥样硬化人群吞咽障碍检出率分别为18%、14%、9%、14%;现病史中高胆固醇血症、高血压、吸烟、糖尿病、房颤、高脂血症患者吞咽障碍检出率分别为19%、22%、19%、22%、22%、10%;既往史中高血压、糖尿病、吸烟、饮酒患者吞咽障碍检出率分别为28%、27%、38%、16%。结论急性脑卒中患者吞咽障碍检出率较高。但受纳入文献质量及数量的限制,上述结论仍需纳入更高质量文献予以考证。
Objective To systematically evaluate the status of dysphagia in patients with acute stroke.Methods PubMed,EMbase,Web of Science,The Cochrane Library,Chinese Biomedical Literature Database(CBM),VIP,CNKI,WanFang and other databases were used to search literatures on the detection rate of dysphagia in patients with acute stroke from the establishment of the database to November 5,2021.Two nursing researchers independently screened the retrieved literatures according to the inclusion and exclusion criteria,extracted data,and evaluated the bias risk of the included literatures.Then Stata16 software was used for Meta analysis.Results A total of 29 articles were included,including 26799 subjects.The prevalence of dysphagia in acute stroke patients was 53%(95%CI:0.46-0.60).Subgroup analysis showed 20%of males(95%CI:0.17-0.22)and 20%of females(95%CI:0.17-0.24).The detection rates were 6%(95%CI:-0.03-0.15)in patients under 50 years old,9%(95%CI:0.04-0.15)in patients 50 to 59 years old,26%(95%CI:-0.04-0.56)in patients 60 to 69 years old,29%(95%CI:0.03-0.54)in patients aged 70-79 years,and 39%(95%CI:-0.24-1.03)in patients aged 80 years or older.The prevalence of dysphagia in cerebral stem,cerebellum,cerebellum,brainstem+cerebellum and brainstem+hemisphere stroke patients was 39%,13%,21%,33%and 90%respectively.The detection rates of swallowing disorders in patients with total anterior circulation infarction(TACI),partial anterior circulation infarction(PACI),posterior circulation infarction(POCI)and lacunar infarction(LACI)were 58%,25%,26%and 16%respectively.The prevalence of dysphagia in patients with cardiogenic stroke,large vessel occlusion,small vessel occlusion and atherosclerosis was 18%,14%,9%and 14%respectively.The prevalence of dysphagia in patients with hypercholesterolemia,hypertension,smoking,diabetes,atrial fibrillation and hyperlipidemia were 19%,22%,19%,22%,22%and 10%respectively.The prevalence of dysphagia in hypertension,diabetes,smoking and drinking was 28%,27%,38%and 16%respectively.Conclusion The rate of dysphagia in acute stroke patients is high.However,due to the limitations of the quality and quantity of the included literatures,the above conclusions still need to be verified by incorporating higher-quality literatures.
作者
杨阳
王珏
刘宁
YANG Yang;WANG Jue;LIU Ning(Department of Nursing Science, Zhuhai Campus, Zunyi Medical University, Zhuhai 519041, China;Institute of Rehabilitation Medicine, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710061, China)
出处
《医学研究与教育》
CAS
2022年第2期54-65,共12页
Medical Research and Education
基金
遵义市科技局遵义医科大学科学技术联合资金项目(遵市科合HZ字(2020)38号)
遵义医科大学2018年度学术新苗培养及创新探索专项项目(黔科合平台人才[2018]5772-045)。
