PDF(Pubmed)
Abstract：
This study was a systematic review and meta-analysis that assessed the risk of aspiration pneumonia in children with laryngeal penetration or tracheal aspiration via a video-fluoroscopic study (VFSS) and compared the results to those for children with neither condition. Systematic searches were conducted using databases, including PubMed, Cochrane Library, and Web of Science. Meta-analysis was used to obtain summary odds ratios (OR) and 95% confidence intervals (CI). The overall quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. In total, 13 studies were conducted with 3159 participants. Combined results from six studies showed that laryngeal penetration on VFSS may be associated with aspiration pneumonia compared to no laryngeal penetration; however, the summary estimate was imprecise and included the possibility of no association (OR 1.44, 95% CI 0.94, 2.19, evidence certainty: low). Data from seven studies showed that tracheal aspiration might be associated with aspiration pneumonia compared to no tracheal aspiration (OR 2.72, 95% CI 1.86, 3.98, evidence certainty: moderate). The association between aspiration pneumonia and laryngeal penetration through VFSS seems to be weaker than that for tracheal aspiration. Prospective cohort studies with clear definitions of laryngeal penetration and that measure clinical and patient reported outcomes are needed to further define the association between laryngeal penetration and aspiration pneumonia.
摘要：
这项研究是一项系统评价和荟萃分析，通过视频透视研究（VFSS）评估了患有喉穿透或气管吸入的儿童的吸入性肺炎的风险，并将结果与两种情况的儿童进行了比较。使用数据库进行了系统搜索，包括PubMed,科克伦图书馆,和WebofScience。采用Meta分析获得汇总比值比(OR)和95%置信区间(CI)。使用建议的分级来评估证据的整体质量，评估，发展,和评估(等级)标准。总的来说,对3159名参与者进行了13项研究。六项研究的综合结果表明，与没有喉部渗透相比，VFSS上的喉部渗透可能与吸入性肺炎有关；但是，汇总估计不精确,包括无关联的可能性(OR1.44,95%CI0.94,2.19,证据确定性:低).来自七项研究的数据表明，与没有气管吸入相比，气管吸入可能与吸入性肺炎有关（OR2.72，95％CI1.86，3.98，证据确定性：中等）。吸入性肺炎与通过VFSS的喉部渗透之间的关联似乎比气管抽吸弱。需要明确定义喉部穿透并测量临床和患者报告结果的前瞻性队列研究，以进一步定义喉部穿透与吸入性肺炎之间的关联。
