脑卒中患者吞咽障碍恢复不良影响因素的Meta分析
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咸阳市科技局重点研发项目 (L2023-ZDYF-SF-055)


Meta-analysis of factors affecting poor recovery of swallowing disorders in stroke patients
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    目的 系统分析脑卒中患者吞咽障碍恢复不良的影响因素。方法 系统检索中国知 网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Embase 数据库,收集 建库至 2022 年 12 月发表的脑卒中患者吞咽障碍恢复不良影响因素相关研究,使用 RevMan 5.4.1 软件 对纳入文献进行Meta分析。结果 共纳入 22 篇文献,4 248 例患者。Meta分析结果显示,年龄≥ 70 岁 (OR=1.53,95%CI:1.29~1.80)、美国国立卫生研究院卒中量表(NIHSS)评分≥ 8 分(OR=2.36,95%CI: 1.53~3.63)、改 良 Rankin 量 表(mRS)评 分 > 0 分(OR=1.71,95%CI:1.40~2.09)、双 侧 卒 中(OR=4.85, 95%CI:2.62~8.97)、低密度脂蛋白(LDL)水平≥3 mg/L(OR=3.70,95%CI:2.46~5.56)、认知障碍(OR=6.23, 95%CI:0.98~39.58)、误吸(OR=4.47,95%CI:3.28~6.11)、气管插管(OR=2.70,95%CI:1.58~4.63)是脑 卒中患者吞咽功能恢复不良的危险因素(P< 0.05);体重指数> 18.5 kg/m2 (OR=0.76,95%CI:0.67~0.86)、 Barthel 指数(BI)> 60 分(OR=0.37,95%CI:0.22~0.62)、功能独立性测评(FIM)评分> 20 分(OR=0.96, 95%CI:0.94~0.99)是脑卒中患者吞咽功能恢复不良的保护因素(P<0.05)。结论 高龄、高NIHSS评分、 双侧卒中、低体重指数、高 mRS 评分、低 BI、低 FIM 评分、高 LDL 水平、合并认知障碍、误吸、气管插管是 脑卒中患者吞咽障碍恢复不良的危险因素,临床可结合影响因素完善吞咽障碍患者的管理措施。

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    Objective To identify the risk factors of poor swallowing function recovery in stroke patients by Meta-analysis. Methods The system searched for relevant studies on the factors affecting the recovery of swallowing disorders in stroke patients published on China National Knowledge Infrastructure, Wanfang Database, VIP, China Biomedical Literature Database, PubMed, Cochrane Library, and Embase Database as of December 2022. The included literature was subjected to Meta-analysis using RevMan 5.4.1 software. Results A total of 22 studies were included, with a sample size of 4 248 cases. The Meta-analysis results showed that age ≥ 70 years (OR=1.53, 95%CI:1.29-1.80), National Institutes of Health Stroke Scale (NIHSS) score ≥ 8 (OR=2.36, 95%CI:1.53-3.63), Modified Rankin Scale (mRS) score > 0 (OR=1.71, 95%CI: 1.40-2.09), bilateral stroke (OR=4.85, 95%CI:2.62-8.97), low-density lipoprotein (LDL) level ≥ 3 mg/L (OR=3.70, 95%CI:2.46-5.56), cognitive impairment (OR=6.23, 95%CI:0.98- 39.58), aspiration (OR=4.47, 95%CI:3.28-6.11), and tracheal intubation (OR=2.70, 95%CI:1.58-4.63) are risk factors for poor swallowing function recovery in stroke patients (P< 0.05). Body Mass Index (BMI) > 18.5 kg/m2 (OR=0.76, 95%CI:0.67-0.86), Barthel index (BI)> 60 (OR=0.37, 95%CI:0.22-0.62), and Functional Independence Assessment (FIM) score > 20 (OR=0.96, 95%CI:0.94-0.99) are protective factors for poor swallowing function recovery in stroke patients (P < 0.05). Conclusions Older age, higher NIHSS score, bilateral infarction, lower BMI, higher mRS score, lower BI, lower FIM score, higher LDL, cognitive disorder, aspiration, intubation duration are risk factors for poor swallowing function recovery in stroke patients. Clinical management measures for swallowing disorder patients can be improved by combining these influencing factors.

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毛怡君,薛常虎,范惠,李尔清,张维,杨薇.脑卒中患者吞咽障碍恢复不良影响因素的Meta分析[J].神经疾病与精神卫生,2024,(3).
DOI :10.3969/j. issn.1009-6574.2024.03.007.

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  • 在线发布日期: 2024-04-07