Article record

口腔卫生护理对住院脑卒中后吞咽困难患者吞咽恢复的影响：系统综述与荟萃分析

Effects of oral hygiene care on swallowing recovery in hospitalised patients with post-stroke dysphagia: a systematic review and meta-analysis.

综述 Meta咽喉科IF 5.7Q1

文献信息

PMID	42911873
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Sungkrit Pojmonpiti 查看其他 5 位作者 Mariska Meersschaut；Katja Batens；Margot Baudelet；Veerle De Herdt；Barbara Janssens
作者单位	ELOHA (Equal Lifelong Oral Health for All) research group, Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium. 查看其他 7 条单位信息 Department of Neurology, Ghent University Hospital, Ghent, Belgium.；Dental Department, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.；Department of Head and Skin, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.；Nuclear Medicine and Molecular Imaging research group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.；Department of Physical Medicine and Rehabilitation, Ghent University Hospital, Ghent, Belgium.；Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.；Department of Oral Health, Ghent University Hospital, Ghent, Belgium.
期刊	European stroke journal
SCI 分区	Q1
IF	5.7
研究类型	综述 Meta · 临床
所属专科	咽喉科

中文摘要

目的： 评估口腔卫生护理对住院脑卒中后吞咽困难（PSD）患者吞咽相关结局的影响。
方法： 系统检索MEDLINE、Embase、Web of Science、Scopus、CINAHL、CENTRAL和ClinicalTrials.gov，截止至2026年5月。纳入报告吞咽相关结局、设有对照组的随机对照试验（RCT）和非随机对照试验（非RCT）。采用RoB 2评估RCT的偏倚风险，采用ROBINS-I评估非RCT的偏倚风险。在适当情况下，采用随机效应模型进行荟萃分析，以估计均数差（MD）、比值比（OR）和风险差（RD）及其95%置信区间（CI）。采用推荐分级的评估、制定与评价（GRADE）框架评估证据确定性。
结果： 共纳入9项研究，包括7项RCT和2项非RCT；RCT的偏倚风险评级从低风险到存在一些担忧不等，非RCT为中等风险。与常规护理相比，口腔卫生护理提高了实现独立经口进食的几率（OR = 2.54，95% CI 1.80；3.59；I2 = 0%），相当于绝对增加13%（RD = 0.13，95% CI 0.03；0.23；I2 = 0%）。功能性经口进食量表（FOIS；评分1-7，评分越高表示经口进食越独立且不受限制）支持口腔卫生护理（MD = 0.40，95% CI 0.07；0.72；I2 = 0%）。同样，Gugging吞咽筛查（GUSS；评分0-20，评估吞咽安全性和吞咽困难严重程度）也支持口腔卫生护理（MD = 2.93，95% CI 1.01；4.85；I2 = 0%）。实现独立经口进食的证据确定性被评为高。
结论： 口腔卫生护理支持PSD患者的吞咽恢复，尤其是独立经口进食，应被视为吞咽困难康复的积极组成部分。

英文摘要

OBJECTIVE: To evaluate the effects of oral hygiene care on swallowing-related outcomes in hospitalised patients with post-stroke dysphagia (PSD).
METHODS: A systematic literature search was conducted in MEDLINE, Embase, Web of Science, Scopus, CINAHL, CENTRAL and ClinicalTrials.gov up to May 2026. Randomised controlled trials (RCTs) and non-RCTs with a comparison group that reporting swallowing-related outcomes were included. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for non-RCTs. Where appropriate, meta-analyses were conducted using random-effects models to estimate mean differences (MDs), odds ratios (ORs) and risk differences (RDs) with 95% confidence intervals (CIs). The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.
RESULTS: Nine studies, comprising 7 RCTs and two non-RCTs, were included, with risk-of-bias ratings ranging from low risk to some concerns for RCTs and moderate risk for non-RCTs. Oral hygiene care increased the odds of achieving independent oral intake compared with usual care (OR = 2.54, 95% CI, 1.80; 3.59; I2 = 0%), corresponding to a 13% absolute increase (RD = 0.13, 95% CI, 0.03; 0.23; I2 = 0%). Functional Oral Intake Scale (FOIS; scores 1-7), with higher scores indicating more independent and unrestricted oral intake, favoured oral hygiene care (MD = 0.40, 95% CI, 0.07; 0.72; I2 = 0%). Similarly, Gugging Swallowing Screen (GUSS; scores 0-20), assessing swallowing safety and dysphagia severity, favoured oral hygiene care (MD = 2.93, 95% CI, 1.01; 4.85; I2 = 0%). The certainty of the evidence for achieving independent oral intake was rated as high.
CONCLUSION: Oral hygiene care supports swallowing recovery in patients with PSD, particularly independent oral intake and should be considered an active component of dysphagia rehabilitation.