一项系统性审查,评估儿童睡眠呼吸障碍患者的吞障碍
Alexander J M Curran1, Sarah Ellis1, May M C Yaneza1,2
1NHS Lanarkshire, University Hospital Monklands, Airdrie, UK.
概括
患有阻塞性睡眠呼吸障碍 (oSDB) 的儿童可能有吞问题的风险增加. 需要进一步的研究来证实这种联系,并指导儿科患者的临床护理.
科学领域:
- 儿科肺病学 儿科肺病学
- 儿科胃肠病学 儿科胃肠病学
- 语音语言病理学 语言病理学
背景情况:
- 睡眠呼吸障碍 (SDB) 影响5%的儿童,并与系统性问题有关.
- 人们担心阻塞性SDB (oSDB) 与吞功能障碍之间的潜在联系,特别是在罕见的致命窒息事件后.
- 这次审查不包括患有神经或面疾病的儿童,以关注oSDB对吞的直接影响.
研究的目的:
- 系统地审查有关儿科阻塞性睡眠呼吸障碍 (oSDB) 和吞障碍之间的相关现有证据.
- 确定患有oSDB的儿童中吞功能障碍的流行和性质.
- 评估证据的质量,并确定未来研究的差距.
主要方法:
- 在主要数据库 (Embase,PubMed,CINAHL,Cochrane) 进行了系统的文献搜索,遵循PRISMA 2020指南.
- 研究包括患有oSDB和吞评估的儿童;排除标准侧重于非英语,综合征,面状况以及缺乏初级数据.
- 使用ROBINS-I工具评估了偏差风险.
主要成果:
- 九项研究符合纳入标准,报告吞功能障碍的患病率从4%到70%.
- 在口腔 (例如,非典型的消) 和喉阶段 (例如,窒息,长时间食) 均观察到异常.
- 证据质量较低,评估工具和研究设计具有显著的异质性;只有三项研究表明oSDB治疗后的潜在改善.
结论:
- 有限,低质量的证据表明,儿科OSDB与吞功能障碍之间存在潜在联系.
- 研究中的异质性阻碍了明确的结论,但临床医生应该考虑患病儿童的吞问题.
- 使用标准化的客观评估进行进一步的研究至关重要,以澄清这种关系并为临床实践提供信息.
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