鼻肠管与鼻胃管在神经外科重症患者中应用效果的Meta分析  

Efficacy of nasojejunal feeding and nasogastric feeding in critically ill neurosurgical patients：a Meta-analysis

作　　者：王濯 沈梅芬[2] 吴超[1] 刘巧艳[1] 

机构地区：[1]苏州大学护理学院,215006 [2]苏州大学附属第一医院神经外科,215006

出　　处：《中国实用护理杂志》2015年第8期601-605,共5页Chinese Journal of Practical Nursing

摘　　要：目的评价鼻肠管和鼻胃管喂养两种营养方式在神经外科重症患者中的应用效果。方法检索PubMed、EMBASE、CochraneLibrary、中国知网全文数据库（cNKI）和中国维普全文数据库（VIP），搜索关于神经外科重症患者应用鼻肠管和鼻胃管喂养的临床随机对照实验文献。采用STATA12．0软件对检索到的文献进行Meta分析。结果17篇文献纳入研究，共计1352例患者。Meta分析结果显示，鼻肠管喂养的患者与鼻胃管喂养的患者相比，在血红蛋白水平[WMD=5．56（2．92～8．20）]、白蛋白水平[WMD-0．78（0．32～1．24）]、前白蛋白水平[WMD=2．06（1．47—2．64）1、肺部感染发生率[RR=0．47（0．37-0．59）]、腹泻发生率【RR=0．64（0．50～0．83）]、消化道出血发生率【RR=0．74（0．58-0．95）]及住院时间[WMD=-2．43（…3．751．10）1方面比较差异有统计学意义；但二者在死亡率上比较差异无统计学意义。结论神经外科重症患者应用鼻肠管营养可提高营养状况，减少并发症，但与死亡率等预后结局的关系尚不明确，有必要开展此方面的高质量、大样本、多中心的随机对照实验。Objective The research aimed to evaluate the efficacy of nasogastric feeding and naso- jejunal feeding in critically ill neurosurgical patients. Methods The randomized controlled trials （RCTs） re- lated to nasogastric feeding and nasojejunal feeding in critically ill neurosurgical patients were collected from PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure （CNKI） and Wanfang Database. Data were analyzed with STATA 12.0 software. Results Seventeen articles with 1 352 patients met the inclu- sion criteria. The Meta-analysis showed that there were significant differences between two groups in hemoglobin level [ WMD=5.56（2.92-8.20） ], albumin level[ WMD=0.78（0.32-1.24） ], prealbumin level [ WMD=2.06（1.47- 2.64） 1, incidence rate of pulmonary infection [ RR=0.47（0.37-0.59） 1, diarrhea [ RR=0.64（0.50-0.83） ] and hemorrhage of digestive tract and length of stay [ WMD=-2.43（-3.75-1.10） ]. However, there was not differ- ence in mortality rate. Conclusions Nasojejunal feeding in critically ill neurosurgical patients can promote nutritional status and reduce complication rate. As the relationship between nasojejunal feeding and mortality rate is unclear, more high quality, large sample, multiple center randomized controlled trials are required.

关 键 词：神经外科 META分析 鼻肠管 鼻胃管 

分 类 号：R473.6[医药卫生—护理学]