预防性留置胃管在胃癌手术中临床价值的Meta分析  

Clinical value of routine nasogastric decompression after gastrectomy for gastric cancer:a meta-analysis of randomized controlled trials

作　　者：陈志辉[1] 宋新明[1] 许开武[1] 秦长江[1] 何裕隆[1] 

机构地区：[1]中山大学附属第一医院胃肠胰外科 中山大学胃癌诊治研究中心,广州510080

出　　处：《消化肿瘤杂志（电子版）》2013年第4期254-260,共7页Journal of Digestive Oncology(Electronic Version)

基　　金：广东省自然基金-重点项目(S2013020012724)

摘　　要：目的探讨预防性留置胃管减压在胃癌手术中的临床价值。方法检索2013年12月1日前所有公开发表的随机对照研究,选择数据库为Pub Med、EMBASE、Web of Science、Cochrane Library。由2名研究员分别独立提取数据和进行文献质量评价,并采用Rev Man 5.2.5软件进行Meta分析。结果共纳入随机对照研究9篇,共计病例1315例,其中留置胃管组658例,不留置胃管组657例。Meta分析结果显示:与留置胃管组相比,不留置胃管组可显著缩短术后进食时间(WMD=0.44,95%CI:0.28~0.60,P【0.01),但不影响患者的术后首次肛门排气时间、术后住院时间、肺部并发症发生率、吻合口瘘发生率、总并发症发生率和死亡率。结论胃癌术后不需要常规预防性留置胃管。Objective To evaluate the necessity and clinical value of routine nasogastric decompression after gastrectomy for gastric cancer. Methods All published randomized controlled trials(RCTs) from Pub Med, EMBASE, Web of Science and Cochrane Library before March 1, 2014 were comprehensively searched for meta-analysis. Data were retrieved and evaluated by two investigators independently, and meta-analysis was performed with Review Manager 5.2.5 software. Results Nine RCTs involving 1315 patients were enrolled in the final analysis, and 658 patients in nasogastric tube decompression group(NG group)and 657 in no-NG group were analyzed. Meta analysis showed that the time to starting oral diet was significantly shorter in the group without decompression(WMD=0.44,95% CI : 0.28~0.60, P<0.01), while the time to anal exhaust, postoperative length of hospital stay, pulmonary complications, anastomotic leak rate, morbidity and mortality did not differ significantly between the NG and no-NG groups. Conclusion Routine nasogastric decompression is unnecessary after gastrectomy for gastric cancer.

关 键 词：胃肿瘤 胃肠减压 胃癌手术 META分析 

分 类 号：R735.2[医药卫生—肿瘤]