Chinese General Practice ›› 2023, Vol. 26 ›› Issue (18): 2293-2300.DOI: 10.12114/j.issn.1007-9572.2022.0603
• Evidence-based Medicine • Previous Articles Next Articles
Received:
2022-06-10
Revised:
2022-09-10
Published:
2023-06-20
Online:
2022-10-27
Contact:
JIANG Yunlan
通讯作者:
蒋运兰
作者简介:
基金资助:
步骤 | 检索式 |
---|---|
#1 | "Deglutition Disorders" [Mesh] |
#2 | dysphagia[Title/Abstract] OR deglutition dysfunction[Title/Abstract] OR deglutition impairment[Title/Abstract] OR deglutition decline[Title/Abstract] OR deglutition disorder*[Title/Abstract] OR swallowing disorder*[Title/Abstract] OR impaired swallowing[Title/Abstract] |
#3 | #1 or #2 |
#4 | "Cardiac Surgical Procedures" [Mesh] |
#5 | Cardiac surgery[Title/Abstract] OR heart surgery[Title/Abstract] OR coronary artery bypass grafting[Title/Abstract] OR CABG[Title/Abstract] OR valv*surgery[Title/Abstract] OR valv* replacement[Title/Abstract] |
#6 | #4 or #5 |
#7 | "Prevalence" [Mesh]OR "Epidemiology" [Mesh]OR "Incidence" [Mesh] |
#8 | Prevalence*[Title/Abstract] OR epidemi*[Title/Abstract] OR incidence*[Title/Abstract] OR frequenc*[Title/Abstract] ORoccurrence*[Title/Abstract] |
#9 | #7 or #8 |
#10 | #3 and #6 and #9 |
Table 1 Strategy for searching studies on incidence of dysphagia after cardiac surgery in PubMed database
步骤 | 检索式 |
---|---|
#1 | "Deglutition Disorders" [Mesh] |
#2 | dysphagia[Title/Abstract] OR deglutition dysfunction[Title/Abstract] OR deglutition impairment[Title/Abstract] OR deglutition decline[Title/Abstract] OR deglutition disorder*[Title/Abstract] OR swallowing disorder*[Title/Abstract] OR impaired swallowing[Title/Abstract] |
#3 | #1 or #2 |
#4 | "Cardiac Surgical Procedures" [Mesh] |
#5 | Cardiac surgery[Title/Abstract] OR heart surgery[Title/Abstract] OR coronary artery bypass grafting[Title/Abstract] OR CABG[Title/Abstract] OR valv*surgery[Title/Abstract] OR valv* replacement[Title/Abstract] |
#6 | #4 or #5 |
#7 | "Prevalence" [Mesh]OR "Epidemiology" [Mesh]OR "Incidence" [Mesh] |
#8 | Prevalence*[Title/Abstract] OR epidemi*[Title/Abstract] OR incidence*[Title/Abstract] OR frequenc*[Title/Abstract] ORoccurrence*[Title/Abstract] |
#9 | #7 or #8 |
#10 | #3 and #6 and #9 |
第一作者 | 发表时间(年) | 国家 | 样本量(例,发病人数/未发病人数) | 年龄(岁,病例组/对照组) | 评估工具 | 手术方式 | 发病率(%) | 研究设计 | 危险因素 | 质量评价(分) |
---|---|---|---|---|---|---|---|---|---|---|
NAKAMURA[ | 2021 | 日本 | 192(15/177) | — | FILS | TAVI/SAVR | 7.81 | 队列研究 | ⑦ | 7 |
BARKER[ | 2009 | 加拿大 | 254(130/124) | 64.5±12.6a | SPBA | CABG/VR等 | 51.18 | 病例对照研究 | ③⑨⑩ | 8 |
ROUSOU[ | 2000 | 美国 | 838(23/815) | — | 吞钡造影检查 | CABG/VR等 | 2.74 | 队列研究 | ③⑨⑪ | 7 |
ZHOU[ | 2019 | 中国 | 395(103/292) | 61.7±12.8a | GUSS | CABG等 | 26.08 | 横断面研究 | ③⑧⑫⑱ | 6 |
MUKDAD[ | 2019 | 美国 | 197(10/187) | 82.7±11.5a | 床旁评估+FEES | TAVR | 5.08 | 队列研究 | ③ | 6 |
程红萍[ | 2018 | 中国 | 158(60/98) | 57.15±10.33a | WST | CABG/VR | 37.97 | 病例对照研究 | ①②③④⑤ | 5 |
丁志威[ | 2018 | 中国 | 386(28/358) | 60.2±8.6 /55.7±9.5 | WST | CABG/VR/ CABG+VR/CHD等 | 7.25 | 病例对照研究 | ④⑤⑥ | 6 |
叶兰[ | 2018 | 中国 | 106(30/76) | 64.5±6.0a | WST | 急诊PCI | 28.30 | 病例对照研究 | ③④⑤ | 6 |
胡可鉴[ | 2016 | 中国 | 452(32/420) | 62±8/58±10 | WST | CABG/VR/ CABG+VR/CHD等 | 7.08 | 病例对照研究 | ③④⑤⑥ | 7 |
周萌[ | 2016 | 中国 | 578(47/531) | 55.59±12.47a | WST | CABG/VR/CABG+VR/CHD等 | 8.13 | 横断面研究 | ③④⑤⑥ | 8 |
DALY[ | 2016 | 新西兰 | 190(33/157) | 61.3±15.0a | SPBA+FEES/VFSS | CABG/VR/HT等 | 17.37 | 病例对照研究 | ⑧⑨⑬ | 8 |
GRIMM[ | 2015 | 美国 | 1 314(115/1 199) | 52~74a | SPBA+ VFSS | CABG/VR/VAD/HT等 | 8.75 | 病例对照研究 | ②③⑦⑧⑮⑯⑲ | 7 |
SKORETZ[ | 2014 | 加拿大 | 909(51/858) | 65.9±12.0a | SPBA | CABG/VR | 5.61 | 病例对照研究 | ①③⑩ | 8 |
FERRARIS[ | 2001 | 美国 | 1 042(31/1 011) | 71.9±8.3 /62.8±11.8 | MBS | CABG等 | 2.98 | 横断面研究 | ⑭⑰⑳ | 7 |
HOGUE[ | 1995 | 美国 | 869(34/835) | 71.0±2.0 /63.0±0.4 | 吞钡造影检查 | CABG/VR/CABG+VR/AS等 | 3.91 | 横断面研究 | ①③⑪ | 8 |
Table 2 Basic information and methodological quality of included studies
第一作者 | 发表时间(年) | 国家 | 样本量(例,发病人数/未发病人数) | 年龄(岁,病例组/对照组) | 评估工具 | 手术方式 | 发病率(%) | 研究设计 | 危险因素 | 质量评价(分) |
---|---|---|---|---|---|---|---|---|---|---|
NAKAMURA[ | 2021 | 日本 | 192(15/177) | — | FILS | TAVI/SAVR | 7.81 | 队列研究 | ⑦ | 7 |
BARKER[ | 2009 | 加拿大 | 254(130/124) | 64.5±12.6a | SPBA | CABG/VR等 | 51.18 | 病例对照研究 | ③⑨⑩ | 8 |
ROUSOU[ | 2000 | 美国 | 838(23/815) | — | 吞钡造影检查 | CABG/VR等 | 2.74 | 队列研究 | ③⑨⑪ | 7 |
ZHOU[ | 2019 | 中国 | 395(103/292) | 61.7±12.8a | GUSS | CABG等 | 26.08 | 横断面研究 | ③⑧⑫⑱ | 6 |
MUKDAD[ | 2019 | 美国 | 197(10/187) | 82.7±11.5a | 床旁评估+FEES | TAVR | 5.08 | 队列研究 | ③ | 6 |
程红萍[ | 2018 | 中国 | 158(60/98) | 57.15±10.33a | WST | CABG/VR | 37.97 | 病例对照研究 | ①②③④⑤ | 5 |
丁志威[ | 2018 | 中国 | 386(28/358) | 60.2±8.6 /55.7±9.5 | WST | CABG/VR/ CABG+VR/CHD等 | 7.25 | 病例对照研究 | ④⑤⑥ | 6 |
叶兰[ | 2018 | 中国 | 106(30/76) | 64.5±6.0a | WST | 急诊PCI | 28.30 | 病例对照研究 | ③④⑤ | 6 |
胡可鉴[ | 2016 | 中国 | 452(32/420) | 62±8/58±10 | WST | CABG/VR/ CABG+VR/CHD等 | 7.08 | 病例对照研究 | ③④⑤⑥ | 7 |
周萌[ | 2016 | 中国 | 578(47/531) | 55.59±12.47a | WST | CABG/VR/CABG+VR/CHD等 | 8.13 | 横断面研究 | ③④⑤⑥ | 8 |
DALY[ | 2016 | 新西兰 | 190(33/157) | 61.3±15.0a | SPBA+FEES/VFSS | CABG/VR/HT等 | 17.37 | 病例对照研究 | ⑧⑨⑬ | 8 |
GRIMM[ | 2015 | 美国 | 1 314(115/1 199) | 52~74a | SPBA+ VFSS | CABG/VR/VAD/HT等 | 8.75 | 病例对照研究 | ②③⑦⑧⑮⑯⑲ | 7 |
SKORETZ[ | 2014 | 加拿大 | 909(51/858) | 65.9±12.0a | SPBA | CABG/VR | 5.61 | 病例对照研究 | ①③⑩ | 8 |
FERRARIS[ | 2001 | 美国 | 1 042(31/1 011) | 71.9±8.3 /62.8±11.8 | MBS | CABG等 | 2.98 | 横断面研究 | ⑭⑰⑳ | 7 |
HOGUE[ | 1995 | 美国 | 869(34/835) | 71.0±2.0 /63.0±0.4 | 吞钡造影检查 | CABG/VR/CABG+VR/AS等 | 3.91 | 横断面研究 | ①③⑪ | 8 |
亚组 | 纳入研究数量(篇) | 异质性检验结果 | 效应模型 | Meta分析结果合并率(95%CI) | |
---|---|---|---|---|---|
I2值(%) | P值 | ||||
地区 | |||||
亚洲 | 7[ | 95.6 | <0.001 | 随机 | 16.6(10.4,22.8) |
北美洲 | 7[ | 97.8 | <0.001 | 随机 | 10.0(6.1,13.8) |
大洋洲 | 1[ | — | — | — | 17.4(12.3,23.5) |
性别 | |||||
男 | 10[ | 96.9 | <0.001 | 随机 | 16.9(11.8,21.9) |
女 | 10[ | 93.1 | <0.001 | 随机 | 16.4(11.1,21.8) |
年龄(岁) | |||||
<70 | 2[ | 97.1 | <0.001 | 随机 | 10.9(8.6,13.5) |
≥70 | 2[ | 93.7 | <0.001 | 随机 | 28.4(19.7,37.9) |
NYHA心功能分级(级) | |||||
Ⅰ~Ⅱ | 9[ | 92.2 | <0.001 | 随机 | 11.8(7.4,16.3) |
Ⅲ~Ⅳ | 7[ | 96.4 | <0.001 | 随机 | 21.0(11.0,30.9) |
围术期气管插管时间(h) | |||||
<12 | 3[ | 0 | 0.43 | 固定 | 1.0(0.3,1.8) |
12~24 | 2[ | 0 | 0.39 | 固定 | 6.4(4.4,8.3) |
25~48 | 2[ | 0 | 0.97 | 固定 | 16.8(9.5,24.1) |
>48 | 4[ | 97.3 | <0.001 | 随机 | 55.0(28.0,82.0) |
慢性肾脏疾病 | |||||
有 | 5[ | 71.8 | 0.014 | 随机 | 13.1(3.8,22.4) |
无 | 5[ | 91.3 | <0.001 | 随机 | 7.1(4.0,10.1) |
慢性肺部疾病 | |||||
有 | 8[ | 81.3 | <0.001 | 随机 | 15.5(7.8,23.2) |
无 | 8[ | 97.4 | <0.001 | 随机 | 12.7(8.3,17.2) |
脑血管意外史 | |||||
有 | 8[ | 93.2 | <0.001 | 随机 | 19.2(10.1,28.4) |
无 | 8[ | 94.3 | <0.001 | 随机 | 9.5(6.5,12.6) |
术前心房颤动史 | |||||
有 | 3[ | 59.2 | 0.086 | 随机 | 22.7(13.4,32.0) |
无 | 3[ | 96.9 | <0.001 | 随机 | 11.7(3.9,19.4) |
术前心力衰竭史 | |||||
有 | 5[ | 96.5 | <0.001 | 随机 | 24.3(9.9,38.6) |
无 | 5[ | 97.1 | <0.001 | 随机 | 10.4(5.8,15.0) |
术中TEE | |||||
使用 | 7[ | 76.6 | <0.001 | 随机 | 10.1(6.8,13.4) |
未使用 | 7[ | 93.9 | <0.001 | 随机 | 7.4(4.1,10.7) |
围术期脑卒中 | |||||
有 | 4[ | 86.9 | <0.001 | 随机 | 56.1(27.4,84.8) |
无 | 4[ | 98.3 | <0.001 | 随机 | 18.6(9.0,28.1) |
围术期败血症 | |||||
有 | 2[ | 32.8 | 0.22 | 固定 | 17.3(8.6,26.0) |
无 | 2[ | 92.5 | <0.001 | 随机 | 5.9(4.5,7.3) |
Table 3 Subgroup analyses of the incidence of dysphagia after cardiac surgery
亚组 | 纳入研究数量(篇) | 异质性检验结果 | 效应模型 | Meta分析结果合并率(95%CI) | |
---|---|---|---|---|---|
I2值(%) | P值 | ||||
地区 | |||||
亚洲 | 7[ | 95.6 | <0.001 | 随机 | 16.6(10.4,22.8) |
北美洲 | 7[ | 97.8 | <0.001 | 随机 | 10.0(6.1,13.8) |
大洋洲 | 1[ | — | — | — | 17.4(12.3,23.5) |
性别 | |||||
男 | 10[ | 96.9 | <0.001 | 随机 | 16.9(11.8,21.9) |
女 | 10[ | 93.1 | <0.001 | 随机 | 16.4(11.1,21.8) |
年龄(岁) | |||||
<70 | 2[ | 97.1 | <0.001 | 随机 | 10.9(8.6,13.5) |
≥70 | 2[ | 93.7 | <0.001 | 随机 | 28.4(19.7,37.9) |
NYHA心功能分级(级) | |||||
Ⅰ~Ⅱ | 9[ | 92.2 | <0.001 | 随机 | 11.8(7.4,16.3) |
Ⅲ~Ⅳ | 7[ | 96.4 | <0.001 | 随机 | 21.0(11.0,30.9) |
围术期气管插管时间(h) | |||||
<12 | 3[ | 0 | 0.43 | 固定 | 1.0(0.3,1.8) |
12~24 | 2[ | 0 | 0.39 | 固定 | 6.4(4.4,8.3) |
25~48 | 2[ | 0 | 0.97 | 固定 | 16.8(9.5,24.1) |
>48 | 4[ | 97.3 | <0.001 | 随机 | 55.0(28.0,82.0) |
慢性肾脏疾病 | |||||
有 | 5[ | 71.8 | 0.014 | 随机 | 13.1(3.8,22.4) |
无 | 5[ | 91.3 | <0.001 | 随机 | 7.1(4.0,10.1) |
慢性肺部疾病 | |||||
有 | 8[ | 81.3 | <0.001 | 随机 | 15.5(7.8,23.2) |
无 | 8[ | 97.4 | <0.001 | 随机 | 12.7(8.3,17.2) |
脑血管意外史 | |||||
有 | 8[ | 93.2 | <0.001 | 随机 | 19.2(10.1,28.4) |
无 | 8[ | 94.3 | <0.001 | 随机 | 9.5(6.5,12.6) |
术前心房颤动史 | |||||
有 | 3[ | 59.2 | 0.086 | 随机 | 22.7(13.4,32.0) |
无 | 3[ | 96.9 | <0.001 | 随机 | 11.7(3.9,19.4) |
术前心力衰竭史 | |||||
有 | 5[ | 96.5 | <0.001 | 随机 | 24.3(9.9,38.6) |
无 | 5[ | 97.1 | <0.001 | 随机 | 10.4(5.8,15.0) |
术中TEE | |||||
使用 | 7[ | 76.6 | <0.001 | 随机 | 10.1(6.8,13.4) |
未使用 | 7[ | 93.9 | <0.001 | 随机 | 7.4(4.1,10.7) |
围术期脑卒中 | |||||
有 | 4[ | 86.9 | <0.001 | 随机 | 56.1(27.4,84.8) |
无 | 4[ | 98.3 | <0.001 | 随机 | 18.6(9.0,28.1) |
围术期败血症 | |||||
有 | 2[ | 32.8 | 0.22 | 固定 | 17.3(8.6,26.0) |
无 | 2[ | 92.5 | <0.001 | 随机 | 5.9(4.5,7.3) |
[1] |
窦祖林. 吞咽障碍评估与治疗[M]. 2版. 北京:人民卫生出版社,2017.
|
[2] |
|
[3] |
|
[4] |
|
[5] |
|
[6] |
|
[7] |
|
[8] |
|
[9] |
|
[10] |
|
[11] |
曾宪涛,刘慧,陈曦,等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志,2012,4(4):297-299.
|
[12] |
|
[13] |
|
[14] |
|
[15] |
程红萍,杨红梅. 心脏手术后患者吞咽困难危险因素调查[J]. 中华现代护理杂志,2018,24(24):2896-2899. DOI:10.3760/cma.j.issn.1674-2907.2018.24.010.
|
[16] |
丁志威,谢周良,权晓强,等. 心脏外科术后发生获得性吞咽障碍的影响因素[J]. 临床医学,2018,38(7):39-41. DOI:10.19528/j.issn.1003-3548.2018.07.15.
|
[17] |
叶兰,张丽淼,李腾. 气管插管呼吸机支持下急诊经皮冠状动脉介入治疗后吞咽障碍的发生率及影响因素分析[J]. 安徽医学,2018,39(11):1373-1376. DOI:10.3969/j.issn.1000-0399.2018.11.021.
|
[18] |
胡可鉴,周萌,梁涛,等. 成人心脏外科术后患者发生获得性吞咽障碍的相关因素研究[J]. 中国循环杂志,2016,31(8):793-796. DOI:10.3969/j.issn.1000-3614.2016.08.016.
|
[19] |
周萌. 心脏术后患者获得性吞咽障碍发生现状及危险因素分析[D]. 北京:北京协和医学院,2016.
|
[20] |
|
[21] |
|
[22] |
|
[23] |
|
[24] |
|
[25] |
|
[26] |
|
[27] |
万娜,王艳玲,张春艳,等. ICU患者获得性吞咽障碍发生现状及危险因素分析[J]. 中国护理管理,2018,18(11):1467-1471. DOI:10.3969/j.issn.1672-1756.2018.11.007.
|
[28] |
|
[29] |
余金甜,陈俊杉,张爱琴. 心脏术后患者发生获得性吞咽障碍危险因素的Meta分析[J]. 中华护理杂志,2020,55(3):451-456. DOI:10.3761/j.issn.0254-1769.2020.03.027.
|
[30] |
任慧玲,黄素芳. 气管插管病人拔管后获得性吞咽困难的研究进展[J]. 护理研究,2015,29(8):904-907.
|
[31] |
|
[32] |
|
[33] |
|
[34] |
|
[35] |
刘妮,郑则广. COPD患者口咽部吞咽障碍研究进展[J]. 国际呼吸杂志,2016,36(21):1652-1656.
|
[36] |
|
[37] |
|
[38] |
|
[39] |
|
[1] | ZHANG Aili, HOU Qiqi, HAN Quanle, ZHANG Boheng, ZHANG Jiawei, CAO Hongxia, ZHANG Chao, CHEN Shuohua, WU Shouling, LI Kangbo. Correlation between Atrial Fibrillation and the Risk of New-onset Chronic Kidney Disease in Northern Chinese Population [J]. Chinese General Practice, 2023, 26(36): 4521-4526. |
[2] | XIE Xuemei, GAO Jing, BAI Dingxi, LU Xianying, HE Jiali, LI Yue. Current Status of Polypharmacy in the Elderly and Its Influencing Factors: a Meta-analysis [J]. Chinese General Practice, 2023, 26(35): 4394-4403. |
[3] | WANG Zhe, DONG Zhihao, ZHENG Hao, KONG Wencheng, ZHANG Yukuan, ZHANG Qiuyue, HAN Jing. Construction of Optimized Treatment Plan of Acupuncture for Migraine Based on Entropy Weight-TOPSIS Method [J]. Chinese General Practice, 2023, 26(34): 4336-4342. |
[4] | ZHU Wenpeng, HAN Mengqi, WANG Yuxin, WANG Guoping. Trends and Projections of Incidence and Mortality of Nasopharyngeal Carcinoma in China from 1990 to 2019 [J]. Chinese General Practice, 2023, 26(34): 4269-4276. |
[5] | WANG Yue, CHEN Qing, LIU Lurong. Detection Rate of Depression and Its Influencing Factors in Chinese Elderly: a Meta-analysis [J]. Chinese General Practice, 2023, 26(34): 4329-4335. |
[6] | JIAN Qiufeng, XU Ronghua, YAO Qian, ZHOU Yuanyuan. A Meta-analysis of the Prevalence and Influencing Factors of Post-stroke Cognitive Impairment in Chinese Elderly Patients [J]. Chinese General Practice, 2023, 26(32): 4070-4079. |
[7] | JIA Yu, ZHOU Zitong, CAO Xuehua, HU Wanqin, XIANG Feng, XIONG Langyu, WANG Xiaoxia. Incidence of Perimenopausal Syndrome in Chinese Women Aged 40 to 65 Years: a Meta-analysis [J]. Chinese General Practice, 2023, 26(32): 4080-4088. |
[8] | LI Jixin, QIU Linjie, REN Yan, WANG Wenru, LI Meijie, ZHANG Jin. The Correlation of Dietary Inflammatory Index with Overweight, Obesity and Abdominal Obesity: a Meta-analysis [J]. Chinese General Practice, 2023, 26(32): 4089-4097. |
[9] | CHEN Xi, ZHANG Juan, LI Lin, ZHANG Jiaqi, WU Yaoli, GUO Hui, WANG Chaoqun. Association between Physical Activity and Risk of All-cause Mortality in Middle-aged and Elderly People in China: a Prospective Cohort Study [J]. Chinese General Practice, 2023, 26(31): 3890-3895. |
[10] | ZHANG Peng, GAO Ying, YANG Hongxi, WAN Chunxiao. Association between Serum Uric Acid Level and the Risk of Chronic Kidney Disease among the Elderly in Longevity Areas of China [J]. Chinese General Practice, 2023, 26(31): 3884-3889. |
[11] | HE Jingyi, WANG Fang, SHUI Xiaoling, LI Ling, LIANG Qian. Efficacy of Non-pharmacological Interventions to Improve Perimenopausal Insomnia Symptoms: a Network Meta-analysis [J]. Chinese General Practice, 2023, 26(31): 3963-3974. |
[12] | ZHANG Dongli, SHEN Chong, ZHANG Weichuan, CHEN Haibin, ZHAO Jianjun. Efficacy and Safety of Programmed Death-1/Programmed Death-1 Ligand Inhibitors in the Treatment of Renal Cell Cancer: a Meta-analysis [J]. Chinese General Practice, 2023, 26(30): 3815-3822. |
[13] | ZHANG Ming, XU Jing, SUN Zhenhua, ZHAO Wenhao, MA Yingqian, ZHANG Jianqiao, SHEN Haiping. Improvement of Nutritional Status of Elderly Patients with Severe Obstruction Esophageal Carcinoma by Image-guided Photodynamic Therapy [J]. Chinese General Practice, 2023, 26(30): 3780-3784. |
[14] | ZHU Lin, GUO Yankui, GAO Chen, CHEN Xuezhi, WANG Fashuai. Efficacy of Western Medicine, Chinese Patent Medicine and Their Combination on Post-stroke Insomnia: a Network Meta-analysis [J]. Chinese General Practice, 2023, 26(30): 3823-3832. |
[15] | HE Yingmei, JIA Xue, ZHU Guojun, LIU Bing. Effect of Serum Uric Acid Longitudinal Trajectory on New-onset Hypertriglyceridemia: a Prospective Cohort Study [J]. Chinese General Practice, 2023, 26(29): 3636-3639. |
Viewed | ||||||||||||||||||||||||||||||||||||||||||||||||||
Full text 640
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||
Abstract 945
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||