脑卒中患者吸入性肺炎危险因素Meta分析

Risk Factors of Aspiration Pneumonia in Stroke Patients:Meta Analysis

目的:系统评价脑卒中患者吸入性肺炎的危险因素,为临床早期预防脑卒中吸入性肺炎提供循证依据。方法:系统检索PubMed、Embase、the Cochrane Library、Web of Science、Sinomed、中国知网、万方、维普等数据库,检索时间为建库至2022年12月31日,使用Review Manager V5.4.1软件进行Meta分析。结果:共纳入30篇文献,包括22项相关危险因素。结果显示,生理因素(年龄、白蛋白)、病理因素(脑卒中伴基础疾病、帕金森病、痴呆、卒中发病部位、吞咽障碍、意识障碍、咳嗽障碍、自主进食障碍、误吸史)、治疗相关因素(使用抑酸剂、鼻饲、鼻饲时长、吸痰、气管切开)、其他因素(体位不当、义齿)为脑卒中吸入性肺炎的危险因素。结论:脑卒中吸入性肺炎的危险因素主要包括生理因素、病理因素、治疗因素和其他因素,临床治疗脑卒中吸入性肺炎时应综合考虑上述因素,采取有效的治疗措施,促进患者及早康复。

OBJECTIVE To systematically evaluate the risk factors and provide evidence-based basis for early clinical prevention of aspiration pneumonia in stroke patients.METHODS Literatures related to the risk factors of aspiration pneumonia in Chinses stroke patients were searched in Pub Med,Embase,the Cochrane Library,Web of Science,Sinomed,CNKI,Wanfang and VIP.The search time was from databases established to December 31^(st) of 2022.Meta-analysis was performed using RevMan 5.4.1.RESULTS30 studies including 22 related risk factors were enrolled.The results showed that physiological factors(age,albumin),pathological factors(with basic diseases,Parkinson's disease,dementia,location of stroke,dysphagia,disturbance of consciousness,cough disorder,autonomic eating disorders,aspiration history,treatment-related factors(use of acid suppressors,nasal feeding,nasal feeding duration,sputum aspiration,tracheotomy),other factors(improper body position,denture,were the risk factors for aspiration pneumonia in stroke patients.CONCLUSION The risk factors of aspiration pneumonia in stroke patients mainly include physiological factors,pathological factors,treatment factors and other factors.In addition,the prevention and treatment focus on hospital patients,and less attention is paid to patients in community,home and nursing institutions.