咽部冷/冰刺激对脑卒中吞咽障碍患者干预效果的系统评价  

Ice/cold Stimulation on Post-stroke with Dysphagia: A Systematic Review

作　　者：李荣清 林文颖[1] 陈锦秀[1] 李壮苗[1] 

机构地区：[1]福建中医药大学护理学院,福建福州350122

出　　处：《康复学报》2017年第5期52-57,共6页Rehabilitation Medicine

基　　金：国家自然科学基金项目(81373709);福建省自然科学基金项目(2014J01350)

摘　　要：目的:评价咽部冷/冰刺激对脑卒中吞咽障碍患者的干预效果。方法:计算机检索The Cochrane Library、EMbase、Web of Science、Pub Med、CBM、Wanfang Data、CNKI及VIP数据库,检索时限均为建库至2016年12月31日。采用Rev Man 5.3软件对数据进行Meta分析。结果:共纳入25项研究,1 936例患者。Meta分析结果显示,治疗总有效率不受咽部冷/冰刺激的干预方式和时间的影响,干预组均高于对照组(P<0.05),在吞咽功能评分[SMD=-1.91,95%CI(-2.48,-1.34),P<0.000 01]、吸入性肺炎发生率[RR=0.30,95%CI(0.18,0.48),P<0.000 01]和营养不良发生率[RR=0.27,95%CI(0.09,0.77),P=0.01]方面,干预组均低于对照组(P<0.05)。结论:咽部冷/冰刺激对脑卒中吞咽障碍患者的吞咽功能具有一定的改善作用,可降低吸入性肺炎、营养不良的发生率,但受纳入研究质量和数量的限制,以上结论尚需更多大样本、多中心、高质量的随机对照试验加以验证。Objective： To evaluate the intervention of ice/cold stimulation on post-stroke with dysphagia. Methods： The Cochrane Library, EMbase, Web of Science, Pub Med, CBM, Wanfang Data, CNKI and VIP database were searched for the randomized controlled trials（RCTs） about the effects of ice/cold stimulation on post-stroke with dysphagia, from the dates of establishment of the databases to December 31, 2016. The data were analyzed by Rev Man 5.3 software. Results： Totally 25 literatures of RCTs including 1,936 patients met the inclusion criterion. The results of meta-analyses showed that the total effective rate was not affected by the means of ice/cold stimulation and duration, the total effective rate of the intervention group was higher than that in the control group, with statistical significance（P0.05）, swallowing disorder functional score[SMD=-1.91, 95%CI（-2.48,-1.34）, P0.000 01], the prevalence rates of aspiration pneumonia[RR=0.30, 95%CI（0.18, 0.48）, P0.000 01]and malnutrition[RR=0.27, 95%CI（0.09, 0.77）,P =0.01]in the intervention group was lower than that in the control group, and the difference was statistically significant（P 0.05）. Conclusion： Ice/cold stimulation on post-stroke with dysphagia can improve the swallowing function, and can reduce the prevalence rates of aspiration pneumonia and malnutrition. However, due to the quality and quantity of inclusive studies is limited, the aforementioned conclusion still needs further confirmation by more rationally designed RCTs with large samples to verify.

关 键 词：脑卒中 吞咽障碍 冷/冰刺激 系统评价 

分 类 号：R493[医药卫生—康复医学] R743.3[医药卫生—临床医学]