13种干预方案治疗脑卒中吞咽困难效果 的网状Meta分析.

OBJECTIVE: To evaluate the application effect of 13 interventions in stroke patients with dysphagia by using network Meta analysis. METHODS: Randomized controlled trials on rehabilitation treatment of stroke associated dysphagia were retrieved from the PubMed, (-ochrane Library, Web of Science, EVIbase,China Biomedical Medicine Database, (- \KI and Wan Fang Data. The screening of literature, extraction of data, and evaluation of the quality of included studies were carried out by two researchers independently. Then network Meta analysis was conducted for studies meeting quality standard using software GeVIT(' and Stata. RESULTS: A total of 46 studies were included, involving 13 interventions. In terms of total effective rate and videofluroscopic swallowing study score (VFSS), there were statistically significant differences between swallowing training, neuromuscular electrical stimulation combined swallowing training, neuromuscular electrical stimulation, electroacupuncture combined with swallowing rehabilitation training, electromyography biofeedback therapy combined swallowing training, acupuncture and conventional nursing (/J<0, 05). Among the indicators of rehabilitation efficiency rate of stroke-associated dysphagia, the treatment effect of electroacu puncture combined with swallowing training was the best. As for VFSS score, the treatment effect of neuromuscular electrical stimulation combined with swallowing training was the best. CONCLUSION: Current evidence showed that, from the aspects of the efficiency and VFSS scores, the comprehensive analysis, electro acupuncture combined with swallowing training or neuromuscular electrical stimulation combined swallowing training is most likely to become the best intervention program. Because electroacupuncture combined with swallowing training is more economical, it is recommended to use during period of reheibilitfLtiorb At same time it should be suggested to choose the appropriate intervention program according to the characteristics of the patients condition.