脑卒中病人合并吞咽障碍影响因素的Meta分析

Influence factors affecting combined dysphagia in stroke patients:a Meta-analysis

目的:系统评价明确脑卒中病人并发吞咽障碍的影响因素。方法:检索中国知网、万方数据库、维普数据库、PubMed、EMbase等有关脑卒中病人并发吞咽障碍影响因素的所有相关文献,检索时限为各数据库建库至2023年6月1日,由2名研究者独立筛选文献、提取数据资料以及评价文献质量,采用RevMan 5.3软件对资料进行Meta分析。结果:共纳入15篇文献,其中英文7篇、中文8篇,样本量为6684例。Meta分析结果显示,年龄[OR=5.41,95%CI(4.52,6.29),P<0.001]、脑卒中严重程度(NIHSS评分)[OR=5.32,95%CI(1.70,8.94),P<0.004]、高血压[OR=2.24,95%CI(1.58,3.19),P<0.001]、糖尿病[OR=1.99,95%CI(1.56,2.54),P<0.001]、脑干出血[OR=1.97,95%CI(1.40,2.78),P<0.001]、肌力<3级[OR=2.56,95%CI(1.71,4.09),P<0.001]为脑卒中病人并发吞咽障碍的影响因素。结论:现有证据表明,年龄越大、NIHSS评分越高、合并糖尿病、高血压等慢性疾病、脑干出血、肌力<3级为脑卒中病人并发吞咽障碍的独立影响因素,临床工作者应尽早地进行筛查,以制定针对性的康复措施,从而降低病人并发吞咽障碍的发病率。

Objective:To determine the influencing factors of dysphagia in stroke patients through Meta-analysis.Methods:The literature related to the influencing factors of dysphagia in stroke patients was retrieved from CNKI,WanFang Database,VIP,PubMed,EMbase.The retrieval time was from the inception to June 1,2023.Two researchers independently screened the literature,extracted data and evaluated the quality of the literature.Meta-analysis of data was performed using RevMan 5.3 software.Results:A total of 15 articles were included,including 7 in English and 8 in Chinese,with a sample size of 6684 cases.The results of Meta-analysis showed that age(OR=5.41,95%CI 4.52-6.29,P<0.001),stroke severity(NIHSS Score)(OR=5.32,95%CI 1.70-8.94,P<0.004),hypertension(OR=2.24,95%CI 1.58-3.19,P<0.001),diabetes(OR=1.99,95%CI 1.56-2.54,P<0.001),brain stem hemorrhage(OR=1.97,95%CI 1.40-2.78,P<0.001),and muscle strength<grade 3(OR=2.56,95%CI 1.71-4.09,P<0.001)were important influencing factors of swallowing disorder in stroke patients.Conclusion:Current evidence shows that the older the age,the higher of the NIHSS score,the combination of chronic diseases such as diabetes,hypertension,brain stem hemorrhage,and muscle strength<grade 3 are independent influencing factors of swallowing disorder in stroke patients.Clinicians should screen these patients as soon as possible to develop targeted rehabilitation measures,so as to reduce the incidence of swallowing disorder in patients.