Abstract:

Objective To identify the risk factors of acquired swallowing disorders among patients after cardiac surgery by meta-analysis. Methods Electronic databases and references of included studies were searched. 2 reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed the quality of included studies. Meta-analysis was conducted by Rev Man 5.3. Results 12 studies were recruited,including 6,527 cases. 22 risk factors of acquired swallowing disorders among patients after cardiac surgery were involved,among which age,chronic lung diseases,chronic kidney diseases,cerebrovascular diseases,congestive heart failure,NYHA functional classification,peri-operative stroke,cardiopulmonary bypass time,aortic block time,endotracheal intubation time and indwelling gastric tube time were independent predictors of acquired swallowing disorders. Conclusion Due to insufficient evidence on the risk factors of acquired swallowing disorders among patients after cardiac surgery and inconsistent evaluation methods of swallowing disorders,more strictly designed studies are needed to further identify the risk factors of acquired swallowing disorders among patients after cardiac surgery.

Key words: Cardiac Surgical Procedures, Deglutition Disorders, Risk Factors, Meta-analysis, Perioperative Nursing

摘要：

目的 通过Meta分析明确心脏术后患者发生获得性吞咽障碍的危险因素。方法 检索中英文数据库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12篇文献,样本量为6 527例。经Meta分析结果显示,年龄、慢性肺部疾病、慢性肾脏疾病、脑血管疾病、充血性心力衰竭、美国纽约心脏病协会心功能分级、围手术期卒中、体外循环时间、主动脉阻断时间、气管插管时间、留置胃管时间具有综合效应,为心脏术后患者发生获得性吞咽障碍的独立预测因素。结论 目前有关心脏术后患者发生获得吞咽障碍危险因素的研究证据尚不足,且由于各研究间吞咽障碍的评估方法差异较大,今后仍需开展控制混杂因素的前瞻性研究进一步明确心脏术后患者发生获得性吞咽障碍的危险因素。

关键词: 心脏外科手术, 吞咽障碍, 危险因素, Meta分析, 围手术期护理