延长胃管置入长度10cm对鼻饲患者相关并发症的影响  

Influences of Extension of Insertion Length of Nasogastric Tube 10 cm on the Relevant Complications of Patients with Nasal Feeding

作　　者：王静[1] 皮红英[1] 郭亮梅[1] 

机构地区：[1]解放军总医院护理部,北京100853

出　　处：《解放军护理杂志》2015年第13期6-10,共5页Nursing Journal of Chinese People's Liberation Army

基　　金：北京市科学技术委员会(D121100004912004)

摘　　要：目的 通过胃管不同置入长度对鼻饲患者相关并发症影响的Meta分析,为临床提供证据支持及指导意见.方法 检索Medline、Embase、Cochrane library、CNKI、万方、维普等6个医学数据库相关文献,时间范围为建库至2014年7月.由2名评价员独立筛选、评价文献和提取数据,对没有异质性的文献进行Meta分析.结果 共纳入4篇文献、422例病例,延长胃管置入10 cm能够降低鼻饲患者的反流率[OR =o.18,95％CI：（0.10～0.34）]、呛咳率[OR=0.19,95％CI：（0.06～0.58）]、误吸率[OR =0.18,95％CI：（0.07～0.42）]、肺炎发生率[OR =0.13,95％CI：（0.04～0.37）]、腹泻发生率等并发症[OR =0.44,95％CI：（0.20～0.95）],但是上消化道出血发生率在延长胃管置入组与常规胃管置入组相似,差异无统计学意义（P＞0.05）.结论 由于最终纳入文献数量偏少,且有些文献质量偏低,对于延长胃管置入长度10 cm能够降低鼻饲患者并发症发生率的结论尚不能完全肯定,须临床进一步深入探讨.Objective Meta analysis was used in the studies regarding the effect of extended insertion length of nasogastric tube on the relevant complications of patients with nasal feeding, so as to provide evi- dence and suggestions for clinicians.Methods Six medical databases were searched,including MEDLINE, EMBASE,Cochrane library,CNKI,WanFang,VIP,and the time ranged from the date of database estab- lished to July 2014.Two qualified reviewers reviewed the original articles,evaluated qualities of articles,and extracted data independently,and the non-heterogeneity was analyzed by using Meta analysis.Results Four original clinical controlled trials were included,containing 422 cases.Extended insertion length of nasogastric tube 10 cm can reduce the patients＇ incidence of reflux （OR = 0.18,95% CI.. （0.10 - 0.34） ）, chocking coughs（OR =0.19,95%CI： （0.06-0.58）） ,aspiration（OR = 0.18,95%CI： （0.07 -0.42）） ,pneumonia（OR = 0.13,95 % CI： （0.04-0.37））, diarrhea（OR = 0.44,95% CI ： （0.20-0.95））, while the result of upper gastroin- testinal hemorrhage showed no statistically significant between two groups （P〉0.05）.Conclusion Due to the less amount of literature included and also the quality of some articles was low,we cannot completely draw the conclusion that extended insertion length of nasogastric tube 10 cm could lower the incidence of complications for the patients with nasal feeding, there is need for further discussion.

关 键 词：胃管 鼻饲 置入长度 并发症 META分析 

分 类 号：R472.9[医药卫生—护理学]