口腔运动干预用于早产儿经口喂养效果的meta分析  

Effects of oral motor intervention on oral feeding in premature infant:a meta-analysis with trial sequential analysis

作　　者：田旭[1] 易莉娟 曾子[1] 帅婷[1] 王燕[2] 宋国敏[3] 

机构地区：[1]天津中医药大学研究生院,天津市300193 [2]天津中医药大学护理学院,天津市300193 [3]天津市天津医院/天津医科大学骨科临床学院护理部

出　　处：《中华护理杂志》2015年第7期804-811,共8页Chinese Journal of Nursing

摘　　要：目的系统评价口腔运动干预(oral motor intervention,OMI)用于对早产儿经口喂养的效果。方法计算机检索PubMed、EMBASE、Web of Science、Cochrane Central of Registration Controlled Trials(CENTRAL)和中国知网(China National Knowledge Infrastructure,CNKI)数据库中关于口腔运动干预对早产儿经口喂养影响的随机对照试验,并追溯合格研究、主题相关研究和综述的参考文献。2名评价者独立检索、筛查文献、提取数据、评价纳入文献的方法学质量并交叉核对后,用RevMan 5.3软件行meta分析,试验序贯分析(trial sequential analysis,TSA)软件估算各结局指标需求信息量(required information size,RIS)。结果共纳入11项随机对照试验,包括855例研究对象。meta分析结果显示,口腔运动干预有助于减少实现完全经口喂养的过渡时间[MD=-4.03,95%CI(-5.22,-2.84),P=0.00]、缩短住院时长[MD=-3.64,95%CI(-5.57,-1.71),P=0.00]、提高喂养效率[MD=0.81,95%CI(0.36,1.27),P=0.00]及摄入奶量比[MD=0.14,95%CI(0.06,0.21),P=0.00],然而在改善早产儿体重方面,口腔运动干预并未显示特殊优势[MD=-17.54,95%CI(-151.34,116.26),P=0.80],敏感性分析和试验序贯分析证实各结局指标的合并结果可信。结论口腔运动干预能有效减少早产儿完全经口喂养过渡时间、住院时间,提高喂养效率和摄入奶量,建议临床推广使用。Objective To assess the effects of oral motor intervention（OMI） on oral feeding in premature infants systematically and objectively. Methods A computerized search in PubMed,EMBASE,Web of Science,CENTRAL and CNKI was performed for relevant randomized controlled trials（RCTs） which investigated the effects of OMI on oral feeding in premature infants relative to conventional alternatives. We manually searched the lists of references of eligible literatures,topic-related literatures and reviews to include any latent studies. Target databases were searched ,captured citations were screened ,data were extracted ,and methodological quality of all eligible studies was assessed accordingly by two independent investigators. Any divergences on eligibility of study were solved based on consensus. Then,meta-analysis and trial sequential analysis were performed by using RevMan 5.3 and TSA soft- ware,respectively. Results Totally 11 RCTs which included 855 participants were incorporated into the meta-anal- ysis. The meta-analysis results well suggested that oral motor intervention effectively reduced the transition time from tube to independent oral feeding[MD=-4.03,95%Cl（-5.22,-2.84）,P=0.00],shorten the length of hospital stays [ MD =-3.64,95% CI （-5.57, - 1.71 ）, P=0.00 ], increased the feeding efficiency [MD =0.81,95% CI （0.36,1.27）, P=0.001 and intake of milk[MD=0.14%,95%CI（0.06%,0.21%）,P=0.00]. However,no difference was identified in terms of weight gain between groups [MD=- 17.54,95% CI （- 151.34,116.26 ）, P=0.801- Meanwhile, sensitivity analysis and TSA confirmed robustness of all pooled results. Conclusion OMI is effective in improving the oral feeding in premature infant,and thus it should be extensively selected to care premature infant.

关 键 词：口腔运动干预 婴儿 早产 META分析 试验序贯分析 

分 类 号：R473.72[医药卫生—护理学]