重症患者ICU获得性吞咽障碍影响因素的Meta分析

doi:10.3761/j.issn.0254-1769.2021.08.019

摘要/Abstract

摘要：

目的通过Meta分析明确重症患者获得性吞咽障碍的影响因素。方法检索中国知网、万方、中国生物医学文献数据库、PubMed、Embase、Cochrane Library数据库,从建库至2021年1月有关重症患者获得性吞咽障碍影响因素的所有文献及纳入文献的参考文献,由2名评价人员按照标准独立筛选文献、提取资料、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23篇文献,样本量为6 145例。Meta分析结果显示,年龄（OR=2.29）、气管插管时间（OR=1.16）、气管切开（OR=4.03）、疾病严重程度（OR=1.35）、颅脑损伤（OR=3.18）、败血症（OR=8.27）、心率失常（OR=3.55）是重症患者获得性吞咽障碍的影响因素。结论年龄越大、气管插管时间长、经历气管切开治疗、疾病严重程度高、伴随颅脑损伤、伴随败血症、伴随心率失常为重症患者发生获得性吞咽障碍的独立危险因素。

关键词: 重症监护病房, 吞咽障碍, 影响因素分析, 护理, Meta分析

Abstract:

Objective To identify the risk factors of acquired swallowing disorders among patients in the intensive care unit by meta-analysis. Methods Electronic databases and references of included studies were searched. 2 reviewers screened the literature according to the inclusion and exclusion criteria,and extracted data,assessed the quality of included studies independently. Meta-analysis was conducted by Rev Man 5.3. Results A total of 23 studies were included,with a sample size of 6 145 cases. The statistically significant risk factors were age（OR=2.29）,endotracheal intubation time（OR=1.16）,tracheotomy（OR=4.03）,disease severity（OR=1.35）,craniocerebral injury（OR=3.18）,sepsis（OR=8.27）,and arrhythmia（OR=3.55）. Conclusion The results of meta-analysis showed that older age,extended intubation duration,tracheostomy,higher severity of medical illness,brain injury,sepsis,arrhythmia were independent predictors for ICU-acquired swallowing disorders.

Key words: Intensive Care Units, Deglutition Disorders, Root Cause Analysis, Nursing Care, Meta-Analysis

戚春霞,厉春林,张雅芝,邹宗颖,黄文娟,李月婷,刘莎莎. 重症患者ICU获得性吞咽障碍影响因素的Meta分析[J]. 中华护理杂志, 2021, 56(8): 1236-1241.

QI Chunxia,LI Chunlin,ZHANG Yazhi,ZOU Zongying,HUANG Wenjuan,LI Yueting,LIU Shasha. Dysphagia in the intensive care unit：a meta-analysis of risk factors[J]. Chinese Journal of Nursing, 2021, 56(8): 1236-1241.

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