持续泵入鼻饲方式对相关并发症影响的系统评价  

Effects of continuous nasogastric feeding on the incidence of complications:a systematic review

作　　者：胡延秋 程云[2] 王银云[1] 

机构地区：[1]复旦大学护理学院,上海200040 [2]复旦大学附属华东医院

出　　处：《护理学杂志》2014年第22期83-87,91,共6页

基　　金：复旦大学护理科研基金项目(FNF201301)

摘　　要：目的系统评价持续鼻饲和间歇鼻饲对并发症发生率的影响。方法计算机检索Cochrane图书馆、JBI循证护理中心图书馆、MEDLINE、EMbase、CINAHL、中国生物医学文献数据库(CBMdisc)、中国知网(CNKI)、中文科技期刊数据库(VIP),收集所有关于持续鼻饲或间歇鼻饲对并发症发生率影响的随机对照试验,同时筛检纳入文献附录的参考文献。由2名研究员按照纳入和排除标准筛选文献并提取资料,参考Cochrane系统评价手册的质量评价标准进行质量评价,使用RevMan5.1软件对符合质量标准的随机对照试验进行meta分析。结果共纳入16项研究。meta分析结果显示,持续泵入鼻饲营养液的方式与传统分次推注营养液的方式比较,腹泻、腹胀、胃潴留、反流、误吸、吸入性肺炎、应激性胃溃疡等并发症发生率差异均有统计学意义(P<0.05,P<0.01)。但是4项关于24h持续泵入与24h间歇泵入两种鼻饲方式的研究结果示,腹泻发生率差异无统计学意义(P>0.05)。结论采取持续鼻饲方案,可以降低腹胀、胃潴留、腹泻、反流、误吸、吸入性肺炎、应激性溃疡等并发症的发生率,进而提高鼻饲的安全性和有效性。Objective To evaluate the influence of continuous versus intermittent nasogastric feeding on the incidence of feeding related complications.Methods The Cochrane Library,JBI Library,MEDLINE （1966-2008）,EMbase （1989-2007）,CINAHL （Cumulative Index to Nursing and Allied Health literature）,CBMdisc （1978-2014）,CNKI （1994-2014） and VIP （1978-2014）were searched to collect randomized controlled trials （RCTs） on the influence of continuous or intermittent nasogastric feeding on the incidence of feeding-related complications.Two reviewers selected and evaluated the studies independently according to Cochrane Handbook.Then,meta-analysis was conducted by using RevMan5.1 software.Results Sixteen RCTs were included.Meta-analysis indicated that continuous nasogastric feeding was associated with lower incidence of diarrhea,abdominal distension,gastric retention,gastroesophageal reflux,aspiration,aspiration pneumonia and stress ulcer than intermittent nasogastric feeding,while there was no statistical difference in diarrhea between the pump-assisted 24-hour continuous feeding and pump-assisted 24-hour intermittent protocol.Conclusion Continuous nasogastric feeding is an effective and safe nasogastric feeding protocol to reduce the incidence of diarrhea,abdominal distension,gastric retention,reflux,aspiration,aspiration pneumonia and stress ulcer.

关 键 词：鼻饲 持续管饲 间歇管饲 并发症 META分析 

分 类 号：R473.6[医药卫生—护理学]