不同输注方式在危重症患者肠内营养支持中效果的系统评价  

Effect of different infusion ways of enteral nutrition support on critically ill patients:A Systematic Review

作　　者：王晓君[1] 许勤[2] 朱姝芹[2] 周婉[2] 

机构地区：[1]淮阴卫生高等职业技术学校,江苏淮安223300 [2]南京医科大学护理学院,江苏南京210029

出　　处：《护士进修杂志》2015年第12期1070-1074,共5页Journal of Nurses Training

摘　　要：目的评价危重症患者EN支持不同输注方式的效果。方法计算机检索Cochrane图书馆、Joanna Briggs(JBI)、PubMed、Embase、Ovid、EBSCO、中国生物医学文献数据库、万方科技期刊全文数据库、中国科技期刊数据库(VIP)、中国学术期刊全文数据库(CNKI)中关于危重症患者EN支持不同输注方式的随机对照试验,采用定性系统评价的方法对纳入文献进行分析。结果共纳入11项随机对照研究,在以经鼻胃途径进行EN支持未合并机械通气的危重症患者为研究对象的5项研究中,4项研究的结果显示:连续输注方式较分次给予方式减少了EN支持患者腹泻的发生率,差异有统计学意义。以合并机械通气的危重症患者作为研究对象的6项研究中,有5项研究评价了两种输注方式对患者腹泻的影响,其中3项研究的结果显示:分次给予方式较连续输注方式减少了EN支持患者腹泻的发生率,差异有统计学意义;3项研究评价了两种输注方式对呕吐、返流的影响,结果显示:分次给予方式较连续输注方式减少了呕吐、返流的发生率,差异有统计学意义。结论经鼻胃途径进行EN支持时,对于未合并机械通气的危重症患者,连续输注方式的效果优于分次给予方式;对于合并机械通气的危重症患者,分次给予方式的效果则优于连续输注方式,但确切的临床效果还需要今后多中心、大样本的随机对照临床试验研究来进一步证实。Objective To evaluate the effect of different infusion ways of enteral nutrition support on critically ill patients .Method The databases of Cochrane Library ,Joanna Briggs（JBI） ,PubMed ,Embase ,Ovid ,EBSCO ,Chi‐nese Biomedical Literature Database ,WanFang Data ,Chinese Science and Techology Periodical Databases （VIP） , China National Knowledge Infrastructure （CNKI） were searched to collect randomized controlled trials （RCTs） and a qualitative systematic review were performed .Result A total of 11 studies were included .In five studies whose re‐search subjects were critically ill patients without mechanical ventilation ,four studies indicated that continuous infu‐sion way significantly reduced the incidence of diarrhea in patients with enteral nuterition support compared with in‐termittent infusion way .In six studies whose research subjects were critically ill patients with mechanical ventila‐tion ,five studies evaluated the effect of two infusion ways on incidence of diarrhea ,three studies indicated that in‐termittent infusion way significantly reduced the incidence of diarrhea compared with continuous infusion way ;three studies evaluated the effect of two infusion ways on incidence of vomit and reflux ,the results indicated that intermit‐tent infusion way significantly reduced the incidence of vomit and reflux compared with continuous infusion way . Conclusion When using enteral nutrition support by nasogastric way ,continuous infusion way is more effective than intermittent infusion way to critically ill patients without mechanical ventilation .Intermittent infusion way is more effective than continuous infusion way to critically ill patients with mechanical ventilation ,but the exact results need to be further confirmed with multi‐center ,large‐scale randomized controlled trials in the future .

关 键 词：肠内营养 输注方式 系统评价 护理 

分 类 号：R472[医药卫生—护理学] R459.3[医药卫生—临床医学]