目的：系统评价不同误吸风险评估工具对脑卒中吞咽障碍患者误吸风险评估的价值。

方法：检索中国知网、万方数据库、维普网、PubMed、Cochrane Library、Web of Science 等数据库，收集自建库起至 2024 年 4 月不同工具评估脑卒中吞咽障碍患者误吸风险的相关文献。通过与金标准比较，计算不同工具诊断误吸的合并敏感度、合并特异度、阳性似然比、阴性似然比、诊断比值比（diagnostic odds ratio，DOR）和曲线下面积（area under the curve，AUC）。

结果：共纳入符合标准的文献17篇，主要纳入4种误吸风险评估工具，分别为洼田饮水试验（Kubota water swallowing test，WST）、标准吞咽功能评估量表（standardized swallowing assessment，SSA）、多伦多床旁吞咽筛查试验（Toronto bedside swallowing screening test，TOR-BSST）、Gussing 吞咽功能评估量表（Gugging swallowing screen，GUSS）。Meta分析结果显示，WST 合并敏感度为 0.57（95% CI：0.51～0.62，P＝0.006）、合并特异度为0.80（95% CI：0.74～0.85，P＝0.014）、DOR＝5.94（95% CI：3.42～10.31，P＝0.153）、AUC为 0.75。SSA 的合并敏感度为 0.87（95% CI：0.82～0.90，P＝0.124）、合并特异度为 0.65（95% CI：0.59～0.71，P＝0.031）、DOR＝11.88（95% CI：5.63～25.07，P＝0.214）、AUC为0.73。TOR-BSST 的合并敏感度为 0.65（95% CI：0.56～0.74，P＝0.004）、合并特异度为0.70（95% CI：0.62～0.77，P＝0.000）、DOR＝3.40（95% CI：2.06～5.62，P＝0.000）、AUC为0.69。GUSS 的合并敏感度为 0.96（95% CI：0.91～0.99，P＝0.425）、合并特异度为 0.62（95% CI：0.52～0.71，P＝0.729）、DOR＝34.71（95% CI：12.39～97.24，P＝0.893）、AUC为0.92。

结论：在脑卒中吞咽障碍患者误吸风险评估中，WST、SSA、TOR-BSST和GUSS均有良好的诊断价值，GUSS的综合诊断效能更高。

Objective: To systematically evaluate the value of different aspiration risk assessment tools for assessing aspiration risk in stroke patients with dysphagia.

Methods: The literatures to evaluate the risk of aspiration in stroke patients with swallowing disorders using different tools were searched from databases including CNKI, Wanfang Database, VIP, PubMed, Cochrane Library, and Web of Science from databases establishment until April 2024. The combined sensitivity, combined specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) of different tools for diagnosing aspiration were calculated comparing with the gold standard.

Results: A total of 17 eligible studies were included, mainly including four risk assessment tools for aspiration, namely Kubota water swallowing test (WST), standardized swallowing assessment (SSA), Toronto bedside swallowing screening test (TOR-BSST), and Gussing swallowing screen (GUSS). The Meta-analysis results showed that the combined sensitivity of WST was 0.57 (95% CI: 0.51-0.62, P＝0.006), combined specificity was 0.80 (95% CI: 0.74-0.85, P＝0.014), DOR was 5.94 (95% CI: 3.42-10.31, P＝0.153), and AUC was 0.75. The combined sensitivity of SSA was 0.87 (95% CI: 0.82-0.90, P＝0.124), combined specificity was 0.65 (95% CI: 0.59-0.71, P＝0.031), DOR was 11.88 (95% CI: 5.63-25.07, P=0.214), and AUC was 0.73. The combined sensitivity of TOR-BSST was 0.65 (95% CI: 0.56-0.74, P＝ 0.004), combined specificity was 0.70 (95% CI: 0.62-0.77, P＝0.000), DOR was 3.40 (95% CI: 2.06-5.62, P＝0.000), and AUC was 0.69. The combined sensitivity of GUSS was 0.96 (95% CI: 0.91-0.99, P＝0.425), combined specificity was 0.62 (95% CI: 0.52-0.71, P＝0.729), DOR was 34.71 (95% CI: 12.39-97.24, P＝0.893), and AUC was 0.92.

Conclusion: For the risk assessment of aspiration in stroke patients with swallowing disorders, WST, SSA, TOR-BSST and GUSS all have good diagnostic values, and GUSS has a higher comprehensive diagnostic efficiency.